       Document 0558
 DOCN  M9630558
 TI    Design and assessment of cost-effectiveness studies in AIDS populations.
 DT    9603
 AU    Simpson KN; Department of Health Policy and Administration, School of
       Public; Health, University of North Carolina at Chapel Hill 27599-7400,;
       USA.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995;10 Suppl 4:S28-32.
       Unique Identifier : AIDSLINE MED/96075587
 AB    Cost-effectiveness (CE) ratios are indicators of comparative efficiency
       of competing drugs. Unfortunately, they are subject to variations,
       depending on factors such as the study population chosen, the comparison
       treatment selected, and the economic analysis methods employed. CE
       ratios tend to be unfavorably skewed in the case of chronic illnesses,
       such as HIV disease, because management of AIDS patients is costly and
       complex. Routine AIDS therapy requires expensive drugs, treatment is
       directed at many disease stages and severities, and gain in patient
       survival is relatively short. Variations in disease stage,
       co-morbidities, and antiviral drug use produce variations in both the
       risk of opportunistic infections (OIs) and the routine costs of OI
       prophylaxis and thus affect the CE ratio. Routine therapy for AIDS
       varies among and even within communities. Overall, these factors
       translate to a widening gap between trial results (efficacy) and
       community outcomes (effectiveness). This article discusses these
       concerns and reviews methodologic issues that must be considered by
       decision-makers using CE analyses to describe a therapy's value.
 DE    Acquired Immunodeficiency Syndrome/DRUG THERAPY/*ECONOMICS  Antiviral
       Agents/ECONOMICS  Cost-Benefit Analysis/*ECONOMICS  Human  Life
       Expectancy  Quality of Life  *Research Design  JOURNAL ARTICLE  REVIEW
       REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

