Background Treatment of human immunodeficiency virus (HIV) infected patients usually involves the use of complex regimens and adverse effects. Current guidelines recommend treatment simplification in patients with effective infection control by switching from Boosted Protease Inhibitors (PI/r) to another group of drugs and by using once daily (qd) schedules where possible in order to improve tolerance and adherence.
Purpose To analyse the results of a pharmaceutical intervention program to promote the simplification of antiretroviral treatment (ART) in HIV+ eligible patients and to assess associated cost savings.
Material and methods Prospective study (July 2013 to April 2014). Adult patients on ART with PI/r-based combinations for more than 6 months, undetectable viral load and no known resistance mutations for Reverse Transcriptase Inhibitors Nucleoside analogues (NNRTIs) were selected. After evaluating the patient, the pharmacist suggested switching the current regimen to a simpler one according with patient characteristics.
Based on the annual cost for each combination, switch-derived savings were calculated.
Results 488 HIV+ patients were treated during the study period, 32% with PI/r combinations. 66 potential candidates for simplification were selected. Pharmaceutical intervention was accepted in 10 patients (15.2%). Of these, 40% were taking atazanavir, 50% lopinavir and 10% fosamprenavir. Main reason for non-acceptance was the lack of updated drug resistance studies. All patients switched, swapped an IP/r for a qd NNRTI (90% rilpivirine and 10% efavirenz). 60% of patients changed to a single tablet regimen.
Overall calculated cost savings were €17,500 per year.
Conclusion A pharmaceutical intervention program of antiretroviral treatment simplification led to cost savings in HIV infection treatment. However the rate of acceptance was low due to lack of updated resistance reports.
References and/or Acknowledgements No conflict of interest.
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