Background Antiretroviral treatment for human immunodeficiency virus type 1 (HIV-1) infection has improved steadily since the advent of combination therapy.
Purpose To assess the prescription patterns and cost of antiretroviral treatment in a tertiary care hospital.
Material and methods Drug treatments for HIV-1 were compared in adult patients affiliated to a tertiary care hospital of the Spanish Health System. All had been in treatment for more than six months (January–June 2014). The data were collected from the institution’s medical records. Annual cost data were calculated by multiplying the monthly up-to-date antiretroviral treatment cost by twelve.
Results 604 patients were treated in this period using a total of 71 different combinations. The age range of patients was from 18 to 65 years and 73.01% were men. The total expenditure for the hospital was €4,267,561 accounting for 16.77% of the whole budget for outpatient treatments. The average cost per patient was €7,065. The seven most common combinations (number of patients,%), their costs (€) and their financial impact on the hospital of the antiretroviral treatments (€, %) were:
Emtricitabine/tenofovir/efavirenz (155, 25.66%), €5,805, (€899,794, 21.08%),
Emtricitabine/tenofovir/rilpivirine (64, 10.60%), €6,723, (€430,241, 10.08%),
Emtricitabine/tenofovir + lopinavir/Ritonavir (52, 8.61%), €8,125, (€422,523, 9.90%),
Emtricitabine/tenofovir + atazanavir/Ritonavir (48, 7.95%), €8,629, (€414,184, 9.71%),
Emtricitabine/tenofovir + darunavir/Ritonavir (28, 4.64%), €8,617, (€241,265, 5.65%),
Emtricitabine/tenofovir + nevirapine (25, 4.14%), €4,489, (€112,218, 2.63%),
Emtricitabine/tenofovir + raltegravir (22, 3.64%), €9,263, (€203,792, 4.78%).
Conclusion Despite the fact that a wide variety of combinations is used for HIV-1, the emtricitabine/tenofovir/efavirenz combo has been by far the most used. It is also one of the cheapest options among the most common therapies. These seven aforementioned options account for almost 64% of antiretroviral costs and cover 65% of the HIV-1 treatments. Additionally it is highly remarkable that all of them are emtricitabine/tenofovir-based therapies.
References and/or acknowledgements We thank the hospital pharmacists for their support.
No conflict of interest.
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