دورية أكاديمية
Healthcare resource utilization and costs in patients with HIV-1 who switched first-line antiretroviral therapy.
| العنوان: | Healthcare resource utilization and costs in patients with HIV-1 who switched first-line antiretroviral therapy. |
|---|---|
| المؤلفون: | Mao J; OptumInsight Inc. - Health Economics and Outcomes Research , Eden Prairie , MN , USA., Johnson MP; OptumInsight Inc. - Health Economics and Outcomes Research , Eden Prairie , MN , USA., McPheeters JT; OptumInsight Inc. - Health Economics and Outcomes Research , Eden Prairie , MN , USA., Prajapati G; Merck and Co Inc. - Center for Observational and Real World Evidence , Kenilworth , NJ , USA., Beyer AP; Merck and Co Inc. - Center for Observational and Real World Evidence , Kenilworth , NJ , USA. |
| المصدر: | Current medical research and opinion [Curr Med Res Opin] 2019 Nov; Vol. 35 (11), pp. 1945-1953. Date of Electronic Publication: 2019 Aug 22. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Informa Healthcare Country of Publication: England NLM ID: 0351014 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-4877 (Electronic) Linking ISSN: 03007995 NLM ISO Abbreviation: Curr Med Res Opin Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1995- : Newbury, Berkshire, U.K. : Informa Healthcare Original Publication: London, M. D. Promotions, ltd. |
| مواضيع طبية MeSH: | HIV-1* , Health Care Costs* , Health Resources* , Patient Acceptance of Health Care*, Anti-HIV Agents/*therapeutic use , HIV Infections/*drug therapy, Adult ; Female ; HIV Protease Inhibitors/therapeutic use ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Reverse Transcriptase Inhibitors/therapeutic use |
| مستخلص: | Objectives: This study compared healthcare utilization and costs associated with switching the first-line protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI) based antiretroviral (ARV) regimen due to reasons other than virologic failure among patients with HIV-1. Methods: This was a retrospective analysis of commercial and Medicare Advantage with Part D enrollees in two US administrative claims databases. The study population comprised adults with HIV-1 infection initiating antiretroviral therapy (ART) on PI- or NNRTI-containing regimens from 1 January 2006 to 31 December 2015. Patients with a subsequent change in anchor agent were assigned to the switch cohort; the non-switch cohort was constructed using propensity score matching of three non-switching patients for each patient in the switch cohort. Patient characteristics and per patient per month healthcare resource utilization and costs were compared between the cohorts during the pre-switch, switch (15 days before and after switching) and post-switch periods. Costs during the switch period were also estimated with a multivariable-adjusted model. Results: The matched study population consisted of 1204 patients who switched their first-line PI- or NNRTI-based regimen and 3612 patients who did not. Compared with the non-switch cohort, patients who switched had higher healthcare resource utilization during the pre-switch, switch and post-switch periods. Mean unadjusted non-ART costs in the switch cohort were nearly double ($2944 versus $1530, p < .001), more than double ($2562 versus $1215, p < .001) and 1.5 times higher ($1473 versus $968, p < .001) than costs in the non-switch cohort in the pre-switch, switch and post-switch periods, respectively. Conclusions: Patients with HIV-1 who initiated PI- or NNRTI-based regimens and switched ARTs for reasons other than virologic failure used more healthcare resources and incurred greater costs relative to patients in the non-switch cohort. This study highlights the importance of initiating patients on appropriate first-line ART to avoid the need to switch due to reasons other than virologic failure. |
| فهرسة مساهمة: | Keywords: Antiretroviral therapy switch; HIV; costs; non-nucleoside reverse transcriptase inhibitor; protease inhibitor; utilization |
| المشرفين على المادة: | 0 (Anti-HIV Agents) 0 (HIV Protease Inhibitors) 0 (Reverse Transcriptase Inhibitors) |
| تواريخ الأحداث: | Date Created: 20190718 Date Completed: 20200702 Latest Revision: 20200702 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1080/03007995.2019.1644850 |
| PMID: | 31311342 |
| قاعدة البيانات: | MEDLINE |
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