Real-World Prescribing of Long-Acting Injectable Cabotegravir for Treatment of HIV in the United States
Author(s)
Rodriguez P, Cartwright B, Gratzl S, Stucky N
Truveta Inc, Bellevue, WA, USA
Presentation Documents
OBJECTIVES: The first long-acting injectable medication for HIV treatment, cabotegravir, was approved by the FDA in January 2021. Real-world usage data for cabotegravir relative to common oral therapies, including bictegravir, remains limited. We describe first-time prescribing patterns and patient characteristics for cabotegravir and bictegravir since January 2021. METHODS: Using a subset of US EHR data supplemented with limited claims from Truveta, we identified patients with HIV first initiating cabotegravir or bictegravir since 2021. We only included patients receiving usual care (at least one encounter in each of the 2 years preceding initiation). We describe patient demographics, comorbidities, and most recent CD4 count per microliter (measure of immune function) in the 12 months before initiation (when available). RESULTS: Overall, 4,493 patients met our inclusion criteria, 496 (11%) initiating cabotegravir and 3,997 (89%) initiating bictegravir. Those initiating cabotegravir had a mean(SD) age of 45.8(13.0), and 76.2% were male, 44.8% were Black or African American race, 38.5% were white race, and 12.7% were Hispanic or Latino ethnicity. For bictegravir, mean(SD) age was 48.5(14.3) and 72.6% were male, 46.2% were Black or African American race, 42.4% were white race, and 10.4% were Hispanic or Latino ethnicity. The ratio of cabotegravir to bictegravir initiation was higher in 2023, compared to 2021. Of those initiating cabotegravir, 41% had previously used bictegravir. The following proportions of patients initiating cabotegravir and bictegravir, respectively, had a history of: Type II diabetes (16% & 17%), cancer (11% & 13%), hepatitis C (7% & 9%) and hepatitis B (4% & 6%). Baseline CD4 values were available for 57% of patients initiating cabotegravir and 35% of patients initiating bictegravir, with mean(SD) levels of 755(360) and 550(376), respectively. CONCLUSIONS: Cabotegravir initiation increased since 2021, but remains rare relative to bictegravir initiation. Patient characteristics were similar overall. Continued monitoring of patient characteristics and trends is needed.
Conference/Value in Health Info
2023-11, ISPOR Europe 2023, Copenhagen, Denmark
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Code
HSD58
Topic
Study Approaches
Topic Subcategory
Electronic Medical & Health Records
Disease
Drugs, Infectious Disease (non-vaccine)