OBJECTIVES: To examine the baseline characteristics and healthcare resource utilization (HCRU) associated with use of MTRs vs. STRs among PWH with and without concurrent MHDs in the US Medicaid population.

METHODS: Anlitiks All Payor Claims data from 01/01/16-06/30/23 were used to identify treatment-naïve Medicaid PWH with MHDs (PWH/MHDs) or PWH without MHDs (PWH/no-MHDs) initiating MTRs or STRs. The date of the first MTR/STR prescription claim during 01/01/17-06/30/22 was the index date. Eligible PWH had ≥ 12-months pre- and post-index continuous enrollment and no pre-index HIV-2 diagnosis. PWH/MHDs and PWH/no-MHDs were categorized based on MHDs diagnosis or treatment during the study period. Pre-index demographics and clinical characteristics and post-index HCRU (i.e., inpatient hospitalizations and ER visits) were described using Chi-square, Wilcoxon rank-sum or t-tests, as appropriate.

RESULTS: Among PWH/MHDs, MTR initiators (n=7,874) were younger (43.6 vs. 47.2 years; p<0.05), less likely to be males (53.6% vs. 64.3%; p<0.05), and more likely to be substance users (32.1% vs 29.4%; p<0.05) than STR initiators (n=46,024). Among PWH/no-MHDs, MTR initiators (n=3,612) were younger (39.2 vs. 43.3 years; p<0.05), less likely to be males (57.7% vs 70.3%; p<0.05), with similar substance use patterns compared to STR initiators (n=23,452). Comorbidity scores and race were similar across all groups. Both groups who initiated MTRs had a higher number (p<0.05) of inpatient hospitalizations (PWH/MHDs: 28.9% vs. 27.1%; PWH/no-MHDs: 13.9% vs. 11.9%) and ER visits (PWH/MHDs: 53.3% vs. 49.2%; PWH/no-MHDs: 35.2% vs. 31.8%) than STR initiators.

CONCLUSIONS: Approximately two-thirds of the PWH population examined had MHDs. PWH/MHDs initiating MTR vs. STR were significantly younger, more likely to be female, had more substance use, and had similar comorbidity and race patterns. Regardless of MHD status, in this Medicaid population PWH initiating MTRs vs. STR experienced significantly higher HCRU.