Cost-Efficacy of Antiretroviral Regimens Recommended in Treatment-Naive HIV-Infected Adults. A Single Center Experience

Round 1

Reviewer 1 Report

I think the study is an innovative one for Romania.

The data is up to date.

Study design is good.

This is a single-center analysis, with a retrospective component.

It should be stated as limitation. 

Otherwise it is acceptable.

Author Response

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Reviewer 2 Report

This is a very well-written paper that addresses a significant medical economic issue.  The authors have used an apparently sound methodology to determine the cost-efficacy structure of combined anti-retroviral therapy for HIV patients in Romania.  I only have two comments:

1. I would imagine that results in other countries may differ depending upon relative differences in the costs of these medications and the selection of tests and cost of patient testing.  Is this worth mentioning in the Discussion section or would this really be "stating the obvious"?
2. Under Methods, please define (spell out) "EACS".

Author Response

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Reviewer 3 Report

The introduction is very weak, although it contains also the literature review. Only the four references are mentioned in this section and it is an extremely low number. The methodology is based on the particular study that was executed three years ago. Is your analysis only a replay of this study? Or how it should be understood? The data description is absolutely missing in this section. The analysis is also very weak itself. It involves no statistical method except from division, when efficacy is calculated. I presume, it should be efficiency. These two terms should not be exchanged. Another point is that the costs displayed on diagram on Figure 1 are tried to be overlaid by a straight line but with no explanation. Each straight line in geometry has assigned its slope that could be interpreted. Here, it is missing. The discussion section involves only one new reference to the scientific study. It is an extremely low number. This section should compare your outcome with the results of other studies. Altogether, there are many crucial shortcomings that need to be edited.

Author Response

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Round 2

Reviewer 3 Report

The literature review is enhanced, but it is still very weak. Only 6 references that are mentioned on the three positions is a very low number. It should be much more enriched. Figure 1 is still not described in the text of the manuscript. The Discussion section is improved, however there is a space to include more comparison.

Author Response

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Author Response File: Author Response.doc