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Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen

Includes bibliographical references.

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Main Author: Lin, Iming
Other Authors: Cleary, Susan
Format: Thesis
Language:English
Published: Health Economics Unit 2014
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access_status_str Open Access
author Lin, Iming
author2 Cleary, Susan
author_browse Cleary, Susan
Lin, Iming
author_facet Cleary, Susan
Lin, Iming
author_sort Lin, Iming
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description Includes bibliographical references.
format Thesis
id oai:open.uct.ac.za:11427/9396
institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:33:43.673Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2014
publishDateRange 2014
publishDateSort 2014
publisher Health Economics Unit
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spelling oai:open.uct.ac.za:11427/9396 Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen Lin, Iming Cleary, Susan Meintjies, Graeme Rebe, Kevin Public Health Includes bibliographical references. In 2003, South Africa's National Department of Health (DoH) initiated the roll out of antiretroviral therapy (ART) for HIV positive individuals in the public health sector. Based on World Health Organization (WHO) guidelines, South Africa's ART programme provides a first line regimen based on a backbone of two nucleoside reverse transcriptase enzyme inhibitors (NRTI) with one non-nucleoside reverse transcriptase inhibitor (NNRTI) while the second line regimen is based on a protease inhibitor (PI) with two NRTIs. Similar to many developing countries, South Africa's NRTI backbone in the first line treatment regimen is stavudine (d4T) combined with lamivudine (3TC), and the NNRTI which is either efavirenz (EFV) or nevirapine (NVP). In some cases, stavudine is replaced with the NRTI zidovudine (AZT) in the first line regimen. Both d4T and AZT have been recognized to contribute to drug related toxicities or side effects, particularly lactic acidosis, lypodystrophy, peripheral neuropathy, and anaemia. However, developing country governments have been limited to these NRTI choices due to the higher cost of alternative treatment options. There is compelling logic that the life long commitment of ART can be made more tolerable, and that adherence among patients and the success of a public sector ART programme can be increased through the provision of ART regimens with the fewest side effects. In addition, the costs and complications associated with treating and managing adverse events associated with d4T and AZT create further burden on the public health sector. By providing tenofovir as an alternative to d4T and AZT in first line ART therapy, the South African government would increase the chance of successful ART therapy for patients and the long-term success of the national ART programme. This cost effectiveness analysis will compare the currently available first line ART options (the status quo) to two alternative options in order to assess the costeffectiveness of the provision of tenofovir in place of d4T/AZT. 2014-11-08T14:30:42Z 2014-11-08T14:30:42Z 2009 Master Thesis Masters MPH http://hdl.handle.net/11427/9396 eng application/pdf Health Economics Unit Faculty of Health Sciences University of Cape Town
spellingShingle Public Health
Lin, Iming
Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen
thesis_degree_str Master's
title Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen
title_full Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen
title_fullStr Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen
title_full_unstemmed Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen
title_short Cost effectiveness analysis of two alternative interventions for the integration of Tenofovir into South Africa's public sector First Line Antiretroviral treatment regimen
title_sort cost effectiveness analysis of two alternative interventions for the integration of tenofovir into south africa s public sector first line antiretroviral treatment regimen
topic Public Health
url http://hdl.handle.net/11427/9396
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