Cost-effectiveness analysis of HLA-B*13:01 screening for the prevention of co-trimoxazole-induced severe cutaneous adverse reactions among HIV-infected patients in Thailand
Issued Date
2023-01-01
Resource Type
ISSN
13696998
eISSN
1941837X
Scopus ID
2-s2.0-85174896399
Pubmed ID
37830976
Journal Title
Journal of Medical Economics
Volume
26
Issue
1
Start Page
1330
End Page
1341
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Medical Economics Vol.26 No.1 (2023) , 1330-1341
Suggested Citation
Kategeaw W., Nakkam N., Kiertiburanakul S., Sukasem C., Tassaneeyakul W., Chaiyakunapruk N. Cost-effectiveness analysis of HLA-B*13:01 screening for the prevention of co-trimoxazole-induced severe cutaneous adverse reactions among HIV-infected patients in Thailand. Journal of Medical Economics Vol.26 No.1 (2023) , 1330-1341. 1341. doi:10.1080/13696998.2023.2270868 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/90901
Title
Cost-effectiveness analysis of HLA-B*13:01 screening for the prevention of co-trimoxazole-induced severe cutaneous adverse reactions among HIV-infected patients in Thailand
Other Contributor(s)
Abstract
Studies found a strong association between HLA-B*13:01 allele and co-trimoxazole-induced severe cutaneous adverse reactions (SCARs). Genetic screening before initiation of co-trimoxazole may decrease the incidence of co-trimoxazole-induced SCARs. This study aims to evaluate the cost-effectiveness of HLA-B*13:01 screening before co-trimoxazole initiation in HIV-infected patients in Thailand. A combination of a decision tree model and a Markov model was used to estimate lifetime costs and outcomes of two strategies including 1) HLA-B*13:01 screening before co-trimoxazole initiation and 2) usual practice from a societal perspective. Alternative drugs are not considered because dapsone (the second-line drug) also presents a genetic risk. Input parameters were obtained from literature, government documents, and part of the TREAT Asia HIV Observational Database (TAHOD). One-way sensitivity analyses and probabilistic analyses were performed to determine robustness of the findings. HLA-B*13:01 screening resulted in 0.0061 quality-adjusted life years (QALYs) loss with an additional cost of 370 THB ($11.84). At the cost-effectiveness threshold of 160,000 THB ($5,112.85), the probability of the genetic screening strategy being cost-effective is 9.54%. This analysis demonstrated that HLA-B*13:01 allele screening before initiation of co-trimoxazole among HIV-infected patients is unlikely to be cost-effective in Thailand. Our findings will help policymakers make an evidence-informed decision making.