Abstract PE11/18
Burden of Adverse Events (AEs) Associated with HIV Antiretroviral Therapy (ART) in the United States Print
M. Dekoven1, C. Makin1, S. Slaff2, M. Marcus1, M. Harbour3, E. Maiese3
1IMS Health, Alexandria, United States, 2Yoh Services LLC, Philadelphia, United States, 3Merck Sharp & Dohme Corp., Whitehouse Station, United States
Objectives: It has been reported that 16% of patients discontinue first-line HIV antiretroviral therapy (ART) due to a drug-related AE1. This study sought to quantify select ART-attributable AE healthcare resource utilization and costs.
Methods: Retrospective study was conducted using the IMS' PharMetrics Plus claims database. Adults with >1 HIV ICD-9-CM diagnosis code (042, V08) during the study period (September 2006-June 2012), >1 claim for an ART prescription between March 2007-June 2011 (index date), and continuous health plan enrollment for >6 months pre- and >12 months post-index were included. Patients with AEs of interest during the pre-index period, diagnosis of pregnancy, HCV, HBV, cancer, or tuberculosis during the study period, or ART claim during the 6 month pre-index period were excluded. Post-index AE episodes were defined as first diagnosis code of an AE with an ART claim < 60 days prior to the start of the episode. A new AE episode occurred if the time interval between two successive AE-associated claims (diagnosis code or AE-associated prescription) was >90 days during the post-index period, except for lipids which was not considered episodic. HIV-associated AE episodes were propensity score matched to identical durations of time from patients without post-index AEs.
A total of 169, 125, and 321 rash, depression, and lipid, respectively, matched episodes were analyzed. Mean time (days) to first occurrence/duration of AE episode was rash 117/15, depression 147/37 and lipids 167/NA. All AE episodes had significantly greater all-cause total prescriptions (p< 0.0001), physician office visits (p< 0.0001) and laboratory/pathology claims (rash; depression: p< 0.0001; lipids: p=0.0054) compared to matched episodes. On average, AE episodes had significantly higher all-cause healthcare costs compared to matched episodes (Table).
These data suggest that the economic burden of ART-attributable AEs should be a key consideration by payers and providers in the management of HIV.

1 Prosperi et al. BMC Infectious Diseases 2012; 12: 269

Assigned speakers:
Mitch Dekoven , IMS Health , Alexandria , United States

Assigned in sessions:
17.10.2013, 12:00-14:00, Poster Session, Poster Session 1, Exhibition
18.10.2013, 12:00-14:00, Poster Session, Poster Session 2, Exhibition