OBJECTIVES

The goal of HIV treatment is to maximize virologic suppression, but for some HTE PLWH, this can be challenging due to multidrug resistance (MDR), intolerability, and non-adherence. This may have an impact on healthcare cost. The study objectives were to describe the clinical characteristics, healthcare resource utilization (HCRU) and cost of HTE and non-HTE PLWH in US Commercial and Medicare Advantage health plans.

METHODS

A retrospective cohort study of PLWH aged 18+ between 01/01/2014-03/31/2018 in the Optum Research Database. Patients were classified as HTE if their regimen indicated a current antiretroviral therapy used to treat MDR and non-HTE if they were treated but not with a HTE regimen. Patients were continuously enrolled 6 months before (baseline) and 12 months after (or until evidence of death) the first HTE or non-HTE regimen identified (follow-up). All variables were summarized descriptively by HTE vs non-HTE and compared using chi-square or two-sample t-tests.

RESULTS

2,566 HTE and 7,461 non-HTE patients were identified. HTE patients were significantly older (53 vs 49 years), more likely to be enrolled in Medicare (38% vs 18%) and had higher mortality (6% vs 3%) in the follow-up period than non-HTE patients. HTE patients had significantly more baseline comorbidities (72% vs 58%) and AIDS-defining conditions (11% vs 6%). Nearly all patients had HIV-related office visits in follow-up. HIV-related Emergency Room (ER) and Inpatient visits were significantly higher among HTE patients (ER=23% vs 12%; Inpatient=16% vs 7%). Among patients with at least one encounter, average cost for ER and IP visits was $640 and $9,162 more for HTE than non-HTE patients, respectively. Similar trends were seen in all-cause HCRU and cost. All reported differences had a significant p-value <0.05.

CONCLUSIONS

The HTE population is complex subgroup of PLWH. They have a high disease burden with more comorbidities and higher cost than non-HTE experienced patients.