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April 22/29, 1998

The Costs of Triple-Drug Anti-HIV Therapy for Adults in the Americas

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(16):1263-1264. doi:10.1001/jama.279.16.1259

To the Editor.—We conducted an analysis to model the potential economic impact of making triple-drug antiretroviral therapy widely available to persons with human immunodeficiency virus (HIV) in selected countries within the Americas.

Model parameters were based, where possible, on empirical data and published research. Based on the percentage of adults who are HIV-positive in the province of British Columbia and treated with antiretroviral therapy in 1997, we assumed that over the course of 1 year 25% of the HIV-positive population would be eligible for therapy. Triple-drug costs were based on average costs of 2 nucleosides (lamivudine plus zidovudine or stavudine) with a protease inhibitor (ritonavir, indinavir, or saquinavir) over the course of 12 months in British Columbia. National seroprevalence levels as of the end of 1994 were reported by the World Health Organization.1 Population and gross national product (GNP) estimates for 1995 were taken from the World Development Report.2