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Are AZT and prophylaxis for pneumocystis carinii pneumonia (PCP) cost-effective?

April 26, 2017azt carinii cost-effective pcp pneumocystis pneumonia PROPHYLAXIS

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Are AZT and prophylaxis for pneumocystis carinii pneumonia (PCP) cost-effective?

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Freedberg K, Tosteson AN, Cohen CJ, Cotton DJ; International Conference on AIDS. Int Conf AIDS. 1990 Jun 20-23; 6: 290 (abstract no. F.D.832). Boston City Hospital, Boston, MA, USA OBJECTIVE: To estimate the impact on life expectancy, direct costs, and cost-effectiveness of AZT and prophylaxis for PCP in asymptomatic HIV-infected persons with CD4 counts below 500/mm3. METHODS: A decision-analytic model, utilizing published natural history data and randomized trial results, was used to compare the following strategies: no therapy (NO RX), AZT alone, PCP prophylaxis with aerosol pentamidine (PRO), or both (AZT+PRO). Total costs included costs of medication (AZT $3,240/year, PRO $1,200/year), monitoring, complications, and treatment. We did separate analyses for those with CD4 counts less than 200 and 200-500 (1-year probability of PCP 18% and 3%, respectively). RESULTS: For CD4 less than 200, PRO increased life expectancy by 0.44 years, and saved $500 per person compared to NO RX. AZT+PR