Presentation (CTI)

OBJECTIVES: HIV treatment in Spain has traditionally relied on daily oral antiretroviral therapy (ART), however this paradigm has evolved with the introduction of an every‑2‑months long‑acting injectable (LAI) regimen of cabotegravir plus rilpivirine, reimbursed since December 2022. Following more than three years of use, this study estimates healthcare resource use (HRU) and associated costs of LAI compared with daily oral ART.
METHODS: A market research quantitative survey (computer‑assisted web interviewing) was conducted from October till November 2025 among 90 hospital professionals (30 HIV specialists, 30 hospital pharmacists and 30 nurses), with experience prescribing, dispensing or administering LAI therapy. Participants reported average annual number of patient visits under daily oral ART and LAI regimens. Annual rates of hospitalizations and emergency department (ED) visits were also collected. HRU estimates were combined with Spanish 2025 unit costs (regional tariffs for outpatient and ED visits; CMBD for hospitalizations) to calculate annual per‑patient HRU‑related costs.
RESULTS: Mean annual visits per patient (oral ART vs LAI) were 2.1 vs 3.4 for HIV specialists, 4.1 vs 5.9 for nursing, and 5.5 vs 3.9 for hospital pharmacy. Corresponding annual per‑patient costs (oral vs LAI) were €810 vs €981 for HIV specialist visits, €65 vs €116 for nursing visits, and €804 vs €366 for hospital pharmacy visits. Hospitalizations (€32 vs €3) and ED visits (€5 vs €1) were lower with LAI. Total annual HRU‑related costs were €1,716 per patient with daily oral ART compared with €1,466 with LAI.
CONCLUSIONS: LAI therapy shifts HRU from hospital pharmacy to clinical and nursing services. On average, daily oral ART results in higher annual per‑patient costs, while LAI treatment is associated with healthcare resource savings from the hospital perspective. Patients receiving LAI and those on oral ART are not necessarily comparable, therefore results should be interpreted with caution.