Healthcare Utilization and Costs Among Treatment-Experienced Medicaid Beneficiaries Utilizing Single-Treatment Versus Multi-Treatment Regimens for HIV


Chen M1, Zachry W1, Afolabi M2, Aweh G2, Chopra I2
1Gilead Sciences, Inc., Foster City, CA, USA, 2STATinMED, LLC, Dallas, TX, USA

OBJECTIVES: This study examined healthcare resource utilization (HCRU) and costs of single-treatment regimens (STRs) versus multi-treatment regimens (MTRs) among treatment-experienced people with HIV (PWH).

METHODS: This cross-sectional retrospective analysis utilized STATinMED RWD Insights data (January 2016—November 2022). Included PWH were enrolled in Medicaid, aged ≥18 years, had pharmacy claims for HIV regimens, a non-diagnostic medical claim for HIV during the study period, and 12 months pre-index and 3 months post-index data. The first HIV regimen claim date was the index date. Exclusions included multiple antiretroviral (ARV) regimens on index date and HIV-2 diagnosis during study period. Outcomes included all-cause and HIV-related HCRU and costs per-patient-per-month (PPPM). Cohorts were matched using inverse probability treatment weighting.

RESULTS: Of 44,099 treatment-experienced PWH, 97.7% had STR use. PWH on STRs vs MTRs were younger (mean: 45 vs 46 years), mostly male (67.3% vs 58.7%), had lower pre-index non-ARV medication use (47.6% vs 55.6%), lower Quan-Charlson Comorbidity Index Score (mean: 5.8 vs 6.0), and lower hepatitis B diagnosis (1.4% vs 2.7%). PWH on STRs vs MTRs had significantly lower all-cause HCRU and costs (P<0.05); fewer pharmacy visits (mean: 1.7 vs 2.5); and lower outpatient ($488 vs $619), pharmacy ($4,772 vs $5,983), and total costs ($5,023 vs $5,933) PPPM. Similarly, PWH on STRs vs MTRs had significantly lower HIV-related HCRU and costs (P<0.05), fewer mean pharmacy (0.9 vs 1.4) and outpatient visits (0.9 vs 1.0), and lower outpatient ($276 vs $329) and pharmacy costs PPPM ($4,053 vs $4,504).

CONCLUSIONS: The results suggest MTR use was more prevalent in women and PWH with more comorbidities. There was excess economic burden among Medicaid-enrolled PWH on MTRs with more comorbidities and more complex ARV treatment histories after balancing for observable differences. Although MTR utilization was low, this may represent a key population in which to intervene to reduce burden.

Conference/Value in Health Info

2023-11, ISPOR Europe 2023, Copenhagen, Denmark

Value in Health, Volume 26, Issue 11, S2 (December 2023)




Economic Evaluation


Infectious Disease (non-vaccine)

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