OBJECTIVES: This study aimed to compare the performances between Markov model and dynamic model in economic evaluations for antiretroviral therapy (ART) of HIV, using a case of bictegravir/emtricitabine/tenofovir (B/F/TAF) for treatment-native adults of HIV-1 infection in China.

METHODS: A Markov model was used to simulate in detail the lifetime treatment of HIV among adult patients with ART with a cycle of one month. A dynamic model was used to consider the effects of ART on preventing transmission among all Chinese adults, with a time frame of 30 years and a cycle of one year. The primary outcomes were total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Sensitivity analyses were conducted for result validation, and the model precision was tested using relative standard deviation (RSD).

RESULTS: In Markov model and dynamic model, compared with dolutegravir/lamivudine (DTG/3TC), B/F/TAF incurred higher per-person expenses ($44,381.33 and $30.94 versus $42,160.13 and $29.28) but yielded superior QALYs (12.7788 and 17.9423 vs 12.6310 and 17.9420), resulting in higher ICER for Markov model compared to dynamic model (14,081.23 vs 6,524.03 USD/QALY). The robustness of the results was confirmed in uncertainty analyses, and Markov model exhibited a lower RSD.