Raltegravir Can Be Used Safely in HIV-1-Infected Patients Treated With Warfarin.

Raltegravir can be used safely in HIV-1-infected patients treated with warfarin.

Filed under: Drug and Alcohol Rehabilitation

Int J STD AIDS. 2012 Dec; 23(12): 903-4
Honda H, Gatanaga H, Aoki T, Watanabe K, Yazaki H, Tanuma J, Tsukada K, Honda M, Teruya K, Kikuchi Y, Oka S

Drug co-administration often affects the patient response to warfarin through various mechanisms. We describe here five HIV-1-infected patients on treatment with warfarin in whom the use of raltegravir was associated with a favourable outcome.
HubMed – drug

Mean cost of a first combination antiretroviral therapy in HIV-infected patients in France, and determinants of expensive drugs prescription.

Filed under: Drug and Alcohol Rehabilitation

Int J STD AIDS. 2012 Dec; 23(12): 865-9
Colombie V, Pugliese-Wehrlen S, Deuffic-Burban S, Cuzin L, Pugliese P, Katlama C, Poizot-Martin I, Raffi F, Cabie A, Dellamonica P, Yazdanpanah Y,

To estimate the cost of the first combination antiretroviral drug therapy (cART) in HIV-infected patients and to determine factors associated with expensive prescriptions, 1698 patients starting cART between September 2002 and September 2007 were selected from the Dat’AIDS cohort. A multivariate linear regression model was used to assess associations between the cost of first cART and patient characteristics, clinical centre and cART adequacy. At cART initiation, the median age was 39 years, median CD4 count was 223 cells/mm(3), median viral load (VL) was 5.2 log copies/mL and 18.3% presented with AIDS. cART was concordant with the French guidelines in 88.7%. The mean cost of cART varied from €26.69/day/person in 2002-2003 to €32.23 in 2006-2007 (P < 0.0001), cost was associated with previous AIDS diagnosis (€31.83/day/person) versus (29.49; P < 0.0001), baseline VL > 5 log copies/mL (€30.99/day/person) versus (28.33; P < 0.0001) and centre. cART regimen not concordant with guidelines were more expensive (€38.31/day/person) versus (29.07; P < 0.0001). After adjusting for the year of initiation, the previous AIDS diagnosis, VL and recommended cART regimen, differences were still found between centres (from €27.81/day/person) to (33.12; P < 0.0001). Cost should be considered when choosing a first cART regimen, especially when considering clinically equivalent regimens. HubMed – drug

Xpert MTB/RIF for diagnosis of TB and drug-resistant TB: a cost and affordability analysis.

Filed under: Drug and Alcohol Rehabilitation

Eur Respir J. 2012 Dec 20;
Pantoja A, Fitzpatrick C, Vassall A, Weyer K, Floyd K

Xpert MTB/RIF is a rapid test to diagnose tuberculosis (TB) and rifampicin-resistant TB. Cost and affordability will influence its uptake.We assessed the cost, globally and in 36 high-burden countries (HBCs), of two strategies for diagnosing TB and multidrug-resistant TB (MDR-TB): Xpert with follow-on diagnostics, and conventional diagnostics. Costs were compared with funding available for TB care and control, and donor investments in HIV prevention and care.Using Xpert to diagnose MDR-TB would cost US$ 0.09 billion/year globally and be lower cost than conventional diagnostics globally and in all HBCs. Diagnosing TB in HIV-positive people using Xpert would also cost about US$ 0.10 billion/year and be lower cost than conventional diagnostics globally and in 33/36 HBCs. Testing everyone with TB signs and symptoms would cost almost US$ 0.47 billion/year globally, much more than conventional diagnostics. However, in European countries, Brazil and South Africa the cost would represent <10% of TB funding.Introducing Xpert to diagnose MDR-TB and to diagnose TB in HIV-positive people is warranted in many countries. Using it to test everyone with TB signs and symptoms is affordable in several middle-income countries, but financial viability in low-income countries requires large increases in TB funding and/or further price reductions. HubMed – drug

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