The Epi-TAF for Tenofovir Disoproxil Fumarate?

Clin Infect Dis. 2016 Apr 1;62(7):915-8. doi: 10.1093/cid/civ1000. Epub 2015 Dec 9.

Abstract

Approximately 84% of human immunodeficiency virus (HIV)-infected US residents on antiretroviral therapy currently receive some form of tenofovir disoproxil fumarate (TDF) as part of their HIV treatment regimen. The TDF analogue tenofovir alafenamide (TAF) has demonstrated equal efficacy but with decreased renal injury and bone mineral density loss compared with TDF. We examine how much more society ought to be willing to pay for TAF over TDF, in exchange for its improved toxicity profile. Using cost-effectiveness methods, we find that current conditions warrant an annual premium of up to $1000 over the average wholesale price (AWP) of TDF. Once generic coformulations of tenofovir/lamivudine become accessible, however, the appropriate premium for TAF will likely merit a downward adjustment, using generic TDF-based costs as the benchmark.

Keywords: cost-effectiveness; costs; generics; tenofovir alafenamide; tenofovir disoproxil fumarate.

MeSH terms

  • Anti-HIV Agents* / adverse effects
  • Anti-HIV Agents* / economics
  • Anti-HIV Agents* / therapeutic use
  • Bone Diseases / chemically induced
  • Cost-Benefit Analysis
  • HIV Infections / drug therapy*
  • HIV Infections / economics
  • Humans
  • Kidney Diseases / chemically induced
  • Tenofovir* / adverse effects
  • Tenofovir* / economics
  • Tenofovir* / therapeutic use
  • United States

Substances

  • Anti-HIV Agents
  • Tenofovir