Health Care Resource Utilization and Cost (HCRU) Among Treatment-Experienced People Living With HIV (PLWH) Switching to Single Tablet Regimen (STR) or Multi-Tablet Regiment (MTR) Triple Therapy Since 2018
Author(s)
Chastek B1, Anderson A1, Webb N1, Rock M2, Gruber J3, Majethia S3, Zachry W3, Cohen J4, Colson A5
1Optum, Eden Prairie, MN, USA, 2Gilead Sciences, Oakland, CA, USA, 3Gilead Sciences, Foster City, CA, USA, 4Joshua P. Cohen Healthcare Analytics, LLC, Boston, MA, USA, 5Access Health, Cambridge, MA, USA
Presentation Documents
OBJECTIVES: Describe HCRU during lines of ARV treatment for PLWH switching to STR or MTR triple therapy.
METHODS: A retrospective study using claims data from the Optum Research Database (01Jan2010 - 31Mar2020). First line of therapy during the study period (01Jan2018 - 31Mar2020) for treatment-experienced adults switching to STR or MTR triple therapy were included. HIV-related HCRU were examined by site of service and compared between STR vs MTR overall and guideline recommended INSTI-based MTR vs. STR. Costs were considered HIV-related if they included a diagnosis of HIV or an AIDS-defining condition. Descriptive analysis of HCRU by site of service (office, outpatient, inpatient stays [IP], ER, and total medical) was conducted following inverse probability treatment weighting (IPTW).
RESULTS: A total of 7456 eligible treatment-experienced PLWH were identified: STR (N=6505, 87%) and MTR (N=951, 13%). 4251(65%) PLWH initiated guideline recommended INSTI-regimens (STR: N=3625, 85%; MTR: N=626, 15%).
Following IPTW, mean[SD] total HIV-related ($3849[3474] vs $4640[6132], P<0.001) and pharmacy costs ($3188[754] vs $3597[869], P<0.001) were significantly lower for PLWH treated with STR vs. MTR.
Mean[SD] medical costs per month were lower for STR vs. MTR $661[3420] vs. $1042[6970], P=0.057. Costs for outpatient services ($139[948] vs $222[1366], P=0.051) and IP stays ($386[2867] vs $688[5412], P=0.096) were numerically lower for STR vs MTR.
Similarly, total HIV-related ($3991[3499] vs $4864[7110], P<0.01) and pharmacy costs ($3293[752] vs $3689[880], P<0.001) were significantly lower for patients treated with INSTI-based STR vs. MTR. Medical costs per month ($698[3460] vs. $1174[7059], P=0.111) and costs by site of service were numerically lower for STR vs. MTR though p-values were not statistically significant.
CONCLUSIONS: HIV-related costs were lowest for patients treated with STR vs MTR driven predominantly by lower pharmacy costs, outpatient costs, and IP costs. Selecting the appropriate treatment regimen may help patients maintain lower health care costs.
Conference/Value in Health Info
Value in Health, Volume 25, Issue 12S (December 2022)
Code
RWD4
Topic
Economic Evaluation, Real World Data & Information Systems, Study Approaches
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Health & Insurance Records Systems
Disease
SDC: Infectious Disease (non-vaccine)