Abstract
Single-tablet regimens (STRs) should be considered for patients with HIV/AIDS to increase medication compliance and improve clinical outcomes. This study compared variations in the prescription trends between STRs and multiple-tablet regimens (MTRs) for treatment-naïve patients with HIV/AIDS after the approval of the new STRs, a proxy indicator for improvement in medication adherence. The medical and pharmacy claim data were retrospectively obtained from the Health Insurance Review and Assessment service, which contains basic information on the patients’ sociodemographic characteristics and treatment information for the entire Korean population. From 2013 to 2018, a total of 6737 patients with HIV/AIDS were included. Most patients were men (92.8%, n = 6251) and insured through the National Health Insurance (95.1%, n = 6410). The mean number of pills in their antiretroviral treatment regimens decreased from 2.8 ± 1.2 in 2013 to 1.2 ± 1.0 in 2018. After the first STR (EVG/c/TDF/FTC) was approved in 2014, prescription transitions from MTR to STR were observed among more than 38% of patients. In 2018, most treatment-naïve patients were prescribed STRs (91.2%). There was a time lag for STR prescription trends in non-metropolitan hospitals compared with those in metropolitan cities. Our data provide a valuable perspective for evaluating ART regimen prescription patterns on a national scale.
Highlights
Single-tablet regimens (STRs) should be considered for patients with human immunodeficiency virus (HIV)/AIDS to increase medication compliance and improve clinical outcomes
Over the 30 years since the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) was first recognized, the HIV/AIDS epidemic has remarkably transitioned from a fatal disease to a chronic illness with patients living with HIV/AIDS1
This consists of partial regimens combining 2 nucleoside reverse transcriptase inhibitors (NRTIs)—zidovudine (ZDV)/lamivudine (3TC), abacavir (ABC)/ lamivudine (3TC), or tenofovir (TDF)/emtricitabine (FTC)—and 1 of the following: boosted protease inhibitor (PI), nonnucleoside reverse transcriptase inhibitors (NNRTIs), or integrase strand transfer inhibitors (INSTIs)[5,6]
Summary
Single-tablet regimens (STRs) should be considered for patients with HIV/AIDS to increase medication compliance and improve clinical outcomes. This study compared variations in the prescription trends between STRs and multiple-tablet regimens (MTRs) for treatment-naïve patients with HIV/AIDS after the approval of the new STRs, a proxy indicator for improvement in medication adherence. Standard ART recommendations stipulate that the regimen contains at least 3 active drugs from 2 or more classes In most cases, this consists of partial regimens combining 2 nucleoside reverse transcriptase inhibitors (NRTIs)—zidovudine (ZDV)/lamivudine (3TC), abacavir (ABC)/ lamivudine (3TC), or tenofovir (TDF)/emtricitabine (FTC)—and 1 of the following: boosted protease inhibitor (PI) (lopinavir/ritonavir), nonnucleoside reverse transcriptase inhibitors (NNRTIs) (efavirenz or rilpivirine), or integrase strand transfer inhibitors (INSTIs) (raltegravir)[5,6]. This study compared variations in the prescription trends between STRs and MTRs for treatment-naïve patients with HIV/AIDS after the approval of the new STRs, a proxy indicator for improvement in medication adherence, using the national insurance claims data in Korea
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