Université de Paris, INSERM, IAME, F-75006, INSERM, Paris, France
AP-HP, Hôpital Bichat, Infectious and Tropical Diseases Department, F-75018 Paris, France.
BMJ Open. 2021 Nov 26;11(11):e046212. doi: 10.1136/bmjopen-2020-046212.
The aim of this study was to evaluate people living with HIV (PLWH) and HIV specialist prescribers' perception of discussing antiretroviral therapy (ART) price in PLWH's care and the acceptability of choosing or switching to various types of less expensive ARTs.
Cross-sectional surveys (one in a convenience sample of PLWH and one in a voluntary response sample of HIV specialist prescribers).
The surveys were conducted among PLHW attending an HIV clinic in the North of Paris (cohort of 4922 PLWH in 2016), and HIV specialists working in French HIV clinics (210 across 12 districts/28), between January and June 2016.
Self-administered questionnaires were constructed using data collected during focus groups with PLWH and prescribers. Pretests were carried out to select the questions and items. Descriptive analyses of the 129 complete questionnaires of PLWH and 79 of prescribers are presented.
Among PLWH, 128/129 were on ART and 54% (69/128) gave a fair estimation of the price of their current regimen. Among prescribers, 24% (19/79) thought that their patients knew this price. Taking into account the price of ART was not perceived as a negative step in the history of French response to HIV epidemic for 53% (68/129) of PLWH and 82% (65/79) of prescribers. Seventy-seven PLWH (60%) would agree to switch to less expensive antiretroviral regimens (as effective and with similar adverse events) if pills were bigger; 42 (33%) if there were more daily doses, and 37 (29%) if there were more pills per dose; prescribers were more circumspect.
A high proportion of PLWH gave a fair estimate of their ART price and this seemed unexpected by HIV specialists. Consideration of drug prices when choosing ART was perceived as conceivable by PLWH and prescribers if effectiveness and tolerance were also considered.
本研究旨在评估感染艾滋病毒（HIV）的患者（PLWH）和 HIV 专科处方医生对讨论 PLWH 治疗中抗逆转录病毒治疗（ART）价格的看法，以及对选择或改用各种价格较低的 ART 的可接受程度。
横断面调查（一项在巴黎北部 HIV 诊所的便利样本中的 PLWH 中进行，另一项在自愿响应样本中的 HIV 专科医生中进行）。
调查于 2016 年 1 月至 6 月期间在巴黎北部 HIV 诊所就诊的 PLHW（2016 年队列中有 4922 名 PLWH）和在法国 HIV 诊所工作的 HIV 专科医生（12 个区/28 个）中进行。
使用与 PLWH 和处方医生进行的焦点小组中收集的数据，自行设计调查问卷。进行了预测试以选择问题和项目。对 129 份完整的 PLWH 问卷和 79 份处方医生问卷进行了描述性分析。
在 PLWH 中，128/129 人正在接受 ART 治疗，54%（69/128）对他们当前方案的价格做出了合理的估计。在处方医生中，24%（19/79）认为他们的患者知道这个价格。考虑到 ART 的价格，53%（68/129）的 PLWH 和 82%（65/79）的处方医生认为这不是法国应对 HIV 流行历史上的负面步骤。如果药丸更大，77 名 PLWH（60%）将同意改用更便宜的抗逆转录病毒方案（同样有效且不良反应相似）；如果每天剂量更多，42 名（33%）；如果每剂量的药丸更多，37 名（29%）；处方医生更加谨慎。
相当一部分 PLWH 对他们的 ART 价格做出了合理的估计，这似乎出乎 HIV 专科医生的意料。PLWH 和处方医生认为，如果同时考虑有效性和耐受性，在选择 ART 时考虑药物价格是可以想象的。
