BACKGROUND: Multiple studies have depicted better viral load suppression and adherence among patients with human immunodeficiency virus (HIV)-1 infection on once-daily fixed-dose single tablet regimens (STR). DOR/TDF/3TC (doravirine/tenofovir/lamivudine) is a novel nonnucleoside reverse transcriptase inhibitor (NNRTI)-based STR approved for initial therapy of adults with HIV-1 infection. It is not yet included in the Russian reimbursement list and its economic evaluation in comparison to a drug already included in the List for the same clinical situation is required.

OBJECTIVES To estimate the annual cost of treatment for DOR/TDF/3TC compared with the STR of rilpivirine/tenofovir/emtricitabine (RPV/TDF/FTC), which is already included in the reimbursement list.

METHODS Indirect treatment comparison (ITC) by Bucher`s method was performed based on DRIVE-AHEAD and STaR trial data, using FDC efavirenz/emtricitabine/tenofovir disoproxil fumarate as common comparator to assess the relative clinical effectiveness of compared STRs. Based on the ITC data, a cost-minimization analysis was run to estimate 1-year costs of DOR/TDF/3TC vs RPV/TDF/FTC. Treatment costs were calculated based on the registered prices for RPV/FTC/TDF and proposed price for DOR/TDF/3TC and converted to EUROs using the exchange rate 1€=76.0698₽.

RESULTS The ITC revealed no significant differences between proportion of participants with <50 HIV-1 RNA copies/mL (FDA snapshot approach) at week 48 with DOR/TDF/3TC and the RPV/TDF/FTC regimen in patients with initial viral load (VL) <100 000 copies/mL (relative risk (RR) 0.914, 95% confidence interval (CI): 0.833–1.003). When compared to RPV/TDF/FTC, one-year therapy with DOR/TDF/3TC was associated with lower costs and saves an average €1,323 (31.4%) per patient.

CONCLUSIONS STR DOR/TDF/3TC provides significant cost-savings to the Russian health care system with non-inferior efficacy to RPV/FTC/TDF in treatment-naive HIV-patients with initial viral load (VL) <100 000 copies/mL.