|Burden of Adverse Events (AEs) Associated with HIV Antiretroviral Therapy (ART) in the United States|| |
|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.
Results: 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).
Conclusion: 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;
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