Background Over the past 30 years, antiretroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) infection has experienced notable changes.
Clinical research has addressed the possibility of simpler treatments. Switching from three drugs to dual-therapy or monotherapy improves adherence to treatment, and reduces unnecessary toxicities and costs.
Purpose The objective of this study is to identify patients with HIV infection who are candidates for simplification of ART to dual-therapy (protease inhibitor boosted with ritonavir or cobicistat – IP/p+lamivudine) or monotherapy (IP/p) and estimates the theoretical savings that would result from modifying the ART.
Material and methods Observational cross-sectional descriptive study that included all patients with ART at the current date (September 2017). Patients with the following criteria were considered to simplify the ART to dual-therapy with IP/p+lamivudine or monotherapy with IP/p: TAR based on two nucleoside inverse transcriptase analogue (ITIAN) inhibitors+IP/p, plasma viral load <50 copies/mL for at least 6 months, absence of failure prior to IP/p and hepatitis B virus markers negative (DNA HBV and HBAg). Data were extracted from the hospital pharmacy dispensing module and electronic health record. The theoretical savings have been calculated by the difference between current and simplified treatment costs (dual-therapy and monotherapy).
Results Four hundred and twenty-two patients were receiving ART, 29 had already received simplified ART. We identified 26/422 who met the criteria for ART simplification.
The annual economic savings estimated in changing ART to dual-therapy would be €78,829.94 and changing ART to monotherapy would be €90,030.74. If this was added to the savings which were generated by the 29 patients who had already simplified ART (€77,567.60) would have resulted in a total annual savings between €156,397.54 and €167,598.34.
Conclusion Our results show that this strategy would lead to considerable savings. In this case, it would save approximately 5.7% to 6.1% of annual expenditure on ART.
No conflict of interest
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