{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:45:41Z","timestamp":1785735941031,"version":"3.56.0"},"reference-count":18,"publisher":"Scientific Scholar","content-domain":{"domain":["ijmr.org.in"],"crossmark-restriction":true},"short-container-title":["Indian J Med Res"],"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Dolutegravir (DTG)-based first line antiretroviral therapy (ART) is preferred globally due to its high efficacy, and tolerability. In India, data on evaluation of its pharmacoeconomic impact with effectiveness and safety remains limited. This study aimed to assess the pharmacoeconomic variables, effectiveness, and safety of the dolutegravir based first line ART regimen among people living with HIV (PLHIV) in south Gujarat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, and observational study was conducted at an ART centre in a tertiary care hospital. Adults (\u226518 yr) receiving first-line ART for \u22656 months were enrolled (n=204) following the informed consent. Pharmacoeconomic outcomes were evaluated using analysis of cost-effectiveness, cost minimisation, cost-utility, and cost-benefit. For effectiveness, CD4 count and plasma viral load (PVL) were recorded at baseline and 6 months. The safety was assessed using causality, severity, and preventability assessment of adverse drug reactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 204 participants, 102 received TLD (tenofovir\/lamivudine\/dolutegravir) and 102 TLE (tenofovir\/lamivudine\/efavirenz). The TLD regimen demonstrated significantly better cost effectiveness (median CER 45.7\n                      <jats:italic>vs.<\/jats:italic>\n                      84.7;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and lower mean annual treatment cost [INR (\u20b9)17,074\n                      <jats:italic>vs<\/jats:italic>\n                      . \u20b919,283;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001]. Quality-adjusted life years (QALY) and disability-adjusted life years (DALY) values were comparable between regimens. Both groups showed significant CD4 improvement over 6 months; inter-regimen differences were non-significant (\n                      <jats:italic>P<\/jats:italic>\n                      =0.386). Viral suppression at 6 months was higher with TLD (99%\n                      <jats:italic>vs<\/jats:italic>\n                      . 92.2%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.019). Fourteen ADRs were reported for TLD group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation and conclusions<\/jats:title>\n                    <jats:p>Dolutegrevir-based regime demonstrated better cost effectiveness, lower annual cost, and more consistent viral load suppression, with comparable immunological recovery and a favourable safety profile, as compared to standard ART regime.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/ijmr_3640_2025","type":"journal-article","created":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T19:47:41Z","timestamp":1785700061000},"page":"252-259","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmaco-economic profile, effectiveness, and safety of a dolutegravir based first line ART regimen among people living with HIV in South Gujarat"],"prefix":"10.25259","volume":"164","author":[{"given":"Brijeshkumar","family":"Sojitra","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetna","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnakant Niranjanbhai","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajal","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paras","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaykumar","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag","family":"Adwani","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Panchal","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Government Medical College, Surat, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"10.25259\/IJMR_3640_2025\/ref-2","doi-asserted-by":"publisher","first-page":"83","DOI":"10.5334\/aogh.4277","article-title":"Advancing the global fight against HIV\/aids: Strategies, barriers, and the road to eradication","volume":"89","author":"Kumah","year":"2023","journal-title":"Ann Glob Health."},{"key":"10.25259\/IJMR_3640_2025\/ref-4","doi-asserted-by":"publisher","first-page":"3547","DOI":"10.2147\/DDDT.S84850","article-title":"Dolutegravir \u2013 A review of the pharmacology, efficacy, and safety in the treatment of HIV","volume":"9","author":"Kandel","year":"2015","journal-title":"Drug Des Devel Ther."},{"key":"10.25259\/IJMR_3640_2025\/ref-5","doi-asserted-by":"publisher","first-page":"2534","DOI":"10.2147\/ceor.s439725","article-title":"The cost-effectiveness of dolutegravir in combination with tenofovir and lamivudine for HIV therapy: A systematic review","volume":"16","author":"Aprilianti","year":"2024","journal-title":"Clinicoecon Outcomes Res."},{"key":"10.25259\/IJMR_3640_2025\/ref-10","first-page":"538","article-title":"Focusing on the preventability of adverse drug reactions","volume":"27","author":"Schumock","year":"1992","journal-title":"Hosp Pharm."},{"key":"10.25259\/IJMR_3640_2025\/ref-11","doi-asserted-by":"publisher","first-page":"2050312117690404","DOI":"10.1177\/2050312117690404","article-title":"Assessment of the expectancy, seriousness and severity of adverse drug reactions reported for chronic obstructive pulmonary disease therapy","volume":"5","author":"Petrova","year":"2017","journal-title":"SAGE Open Med."},{"key":"10.25259\/IJMR_3640_2025\/ref-12","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.jval.2014.08.2516","article-title":"A systematic review of cost-effectiveness analysis of CD4 cell count versus HIV viral load in primarily resource-limited settings","volume":"17","author":"Hu","year":"2014","journal-title":"Value Health."},{"key":"10.25259\/IJMR_3640_2025\/ref-13","first-page":"362","article-title":"Pharmacoeconomics: Principles, methods and economic evaluation of drug therapies","volume":"2","author":"Kumar","year":"2013","journal-title":"PharmTechMedica."},{"key":"10.25259\/IJMR_3640_2025\/ref-15","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1177\/1742395312466903","article-title":"Just give me the best quality of life questionnaire: The Karnofsky scale and the history of quality of life measurements in cancer trials","volume":"9","author":"Timmermann","year":"2013","journal-title":"Chronic Illn."},{"key":"10.25259\/IJMR_3640_2025\/ref-17","doi-asserted-by":"publisher","first-page":"65564","DOI":"10.1007\/s41669-021-00275-6","article-title":"Cost-utility analysis of dolutegravir- versus efavirenz-based regimens as a first-line treatment in adult HIV\/AIDS patients in Ethiopia","volume":"5","author":"Belay","year":"2021","journal-title":"Pharmacoecon Open."},{"key":"10.25259\/IJMR_3640_2025\/ref-18","doi-asserted-by":"publisher","first-page":"e193200","DOI":"10.1016\/s2352-3018(19)30400-x","article-title":"Updated assessment of risks and benefits of dolutegravir versus efavirenz in new antiretroviral treatment initiators in sub-Saharan Africa: Modelling to inform treatment guidelines","volume":"7","author":"Phillips","year":"2020","journal-title":"Lancet HIV."},{"key":"10.25259\/IJMR_3640_2025\/ref-19","doi-asserted-by":"publisher","first-page":"S17382","DOI":"10.1097\/qad.0000000000003068","article-title":"Cost and cost-effectiveness of dolutegravir-based antiretroviral regimens: An economic evaluation of a clinical trial","volume":"35","author":"Jamieson","year":"2021","journal-title":"AIDS."},{"key":"10.25259\/IJMR_3640_2025\/ref-20","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/1758-2652-14-15","article-title":"Driving a decade of change: HIV\/AIDS, patents and access to medicines for all","volume":"14","author":"Hoen E\u2019","year":"2011","journal-title":"J Int AIDS Soc."},{"key":"10.25259\/IJMR_3640_2025\/ref-22","first-page":"18","article-title":"Effectiveness and common side effects of Dolutegravir compared to Efavirenz-based regimens of combined antiretroviral therapy","volume":"5","author":"Mambo","year":"2023","journal-title":"J Prev Rehabilitative Med."},{"key":"10.25259\/IJMR_3640_2025\/ref-23","first-page":"336","article-title":"Assessment of quality of life among people living with HIV\/AIDS in a tertiary care center \u2013 a cross-sectional study","volume":"6","author":"Nagesh","year":"2024","journal-title":"J Acad Med Prac."},{"key":"10.25259\/IJMR_3640_2025\/ref-25","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12879-021-06991-y","article-title":"Dolutegravir plus lamivudine versus efavirenz plus tenofovir disoproxil fumarate and lamivudine in antiretroviral-naive adults with HIV-1 infection","volume":"22","author":"Deng","year":"2022","journal-title":"BMC Infect Dis."},{"key":"10.25259\/IJMR_3640_2025\/ref-26","doi-asserted-by":"publisher","first-page":"e40139","DOI":"10.7759\/cureus.40139","article-title":"Treatment outcomes of dolutegravir- versus efavirenz-based highly active antiretroviral therapy regimens among treatment-naive people living with HIV","volume":"15","author":"Mahale","year":"2023","journal-title":"Cureus."},{"key":"10.25259\/IJMR_3640_2025\/ref-27","doi-asserted-by":"publisher","first-page":"43443","DOI":"10.1093\/cid\/ciae361","article-title":"Challenges for novel antiretroviral development in an era of widespread tenofovir-disoproxil\/lamivudine (or emtricitabine)\/dolutegravir availability (TLD) availability","volume":"80","author":"Fairhead","year":"2025","journal-title":"Clin Infect Dis."},{"key":"10.25259\/IJMR_3640_2025\/ref-28","first-page":"1","article-title":"Dolutegravir reported adverse drug reactions: A systematic review","volume":"13","author":"Wadesango","year":"2022","journal-title":"Res Sq."}],"container-title":["The Indian Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ijmr.org.in\/pharmaco-economic-profile-effectiveness-and-safety-of-a-dolutegravir-based-first-line-art-regimen-among-people-living-with-hiv-in-south-gujarat\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ijmr.org.in\/pharmaco-economic-profile-effectiveness-and-safety-of-a-dolutegravir-based-first-line-art-regimen-among-people-living-with-hiv-in-south-gujarat\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:24:41Z","timestamp":1785734681000},"score":1,"resource":{"primary":{"URL":"http:\/\/ijmr.org.in\/pharmaco-economic-profile-effectiveness-and-safety-of-a-dolutegravir-based-first-line-art-regimen-among-people-living-with-hiv-in-south-gujarat\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":18,"alternative-id":["10.25259\/IJMR_3640_2025"],"URL":"https:\/\/doi.org\/10.25259\/ijmr_3640_2025","relation":{},"ISSN":["0971-5916"],"issn-type":[{"value":"0971-5916","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"article-number":"252"}}