Bictegravir/emtricitabine/tenofovir alafenamide (B/FTC/TAF, BIKTARVY) is an oral single-tablet regimen (STR) with the indication for the treatment of HIV type 1 (HIV-1) infection in adults with no known substitution associated with resistance to the individual components of B/FTC/TAF. It contains bictegravir (B), an unboosted integrase strand transfer inhibitor (INSTI), as well as emtricitabine (FTC) and tenofovir alafenamide (TAF), nucleoside reverse transcriptase inhibitors (NRTIs). B/FTC/TAF is available as a fixed-dose combination of 50 mg of B (equivalent to 52.5 mg of bictegravir sodium), 200 mg of FTC, and 25 mg of TAF (equivalent to 28 mg of tenofovir alafenamide fumarate) tablet, taken once daily. At the manufacturer-submitted price of $39.22 per tablet, the annual cost of treatment is approximately $14,315 per patient. The manufacturer is seeking reimbursement in accordance with the Health Canada indication.
The manufacturer submitted a cost-utility analysis based on a Markov cohort model, which estimated the incremental costs and health outcomes associated with B/FTC/TAF compared with some of the treatments recommended by the US Department of Health and Human Services (DHHS) guidelines:
Abacavir/dolutegravir/lamivudine (ABC/DTG/3TC) (Triumeq)
Emtricitabine/tenofovir alafenamide (FTC/TAF) (Descovy) + dolutegravir (DTG) (Tivicay)
Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/FTC/TAF) (Genvoya)
Emtricitabine/tenofovir alafenamide (FTC/TAF) (Descovy) + raltegravir (RAL) (Isentress).
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