Background In recent years, simplification of antiretroviral therapy is increasingly being recognised as an attractive therapeutic alternative for cost minimization. Currently, this kind of treatment is used in patients without a prior history of failure of protease inhibitors (PIs), with an undetectable viral load for the last 6 months and signs or symptoms of toxicity from nucleoside analogues.
Purpose To describe the cost savings that have been achieved by changing triple therapy in antiretroviral treatment to monotherapy with a protease inhibitor (PI) boosted with ritonavir in HIV patients.
Material and methods Cross-sectional study in which all patients who were on antiretroviral monotherapy on a particular date (1 March 2014) were included. The following variables obtained from the SAP application were recorded: the current and previous treatment, as well as the duration of each of the schemes. The prices of antiretroviral drugs used were those for which the Pharmacy Department had acquired them.
Results A total of 953 patients were on antiretroviral treatment on 1 March 2014, 33 of whom were prescribed monotherapy boosted with ritonavir; 21 with darunavir/ritonavir and 12 with lopinavir/ritonavir. Median duration of treatment was 23 months (standard deviation (SD) = 18.69). The treatment simplification in these patients has meant savings of €263.000 (monthly average of €286 per patient (SD = €156)). The simplifications that showed higher rates of reduction of direct acquisition costs of the drugs were the switching of atazanavir/ritonavir+ tenofovir + abacavir for darunavir/ritonavir (−55% (€449/month/patient)), and atazanavir/ritonavir + tenofovir+ efavirenz for lopinavir/ritonavir (−52% (€446/month/patient)).
Conclusion Simplification of antiretroviral therapy translates to an average monthly saving of 290 euros per patient, which has meant savings of €260,000 euros in comparison to the previous treatment these 33 patients had received. It is necessary to carry out more studies to corroborate that simplified antiretroviral therapy is, besides being financially attractive, a strategy as effective as traditional antiretroviral therapy.
References and/or acknowledgements No conflict of interest.
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