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与每日口服抗 HIV 治疗相比,在西班牙国家卫生保健系统中实施每 2 个月注射 1 次卡替拉韦/利匹韦林长效方案的潜在医疗资源利用和相关成本。

Potential healthcare resource use and associated costs of every 2 month injectable cabotegravir plus rilpivirine long-acting regimen implementation in the Spanish National Healthcare System compared to daily oral HIV treatments.

机构信息

GSK, C. de Severo Ochoa, Tres Cantos, Madrid, 28760, España.

ViiV Healthcare, Tres Cantos, Madrid, España.

出版信息

BMC Infect Dis. 2024 Aug 2;24(1):775. doi: 10.1186/s12879-024-09595-4.

Abstract

INTRODUCTION

HIV treatment currently consists of daily oral antiretroviral therapy (ART). Cabotegravir + rilpivirine long-acting (CAB + RPV LA) is the first ART available in Spain administered every 2 months through intramuscular injection by a healthcare professional (HCP). The objective of this analysis was to assess potential healthcare resource use (HRU) and cost impact of implementing CAB + RPV LA vs. daily oral ART at National Health System (NHS) hospitals.

METHODS

Online quantitative interviews and cost analysis were performed. Infectious disease specialists (IDS), hospital pharmacists (HP) and nurses were asked about their perception of potential differences in HRU between CAB + RPV LA vs. daily oral ART, among other concepts of interest. Spanish official tariffs were applied as unit costs to the HRU estimates (€2022).

RESULTS

120 responders (n = 40 IDS, n = 40 HP, n = 40 nurses) estimated an average number of annual visits per patient by speciality (IDS, HP, and nurse, respectively) of 3.3 vs. 3.7; 4.4 vs. 6.2; 6.1 vs. 3.9, for CAB + RPV LA vs. daily oral ART, and 3.0 vs. 3.2; 4.8 vs. 5.8; 6.9 vs. 4.9, respectively when adjusting by corresponding specialist responses. Estimation by the total sample led to an annual total cost per patient of €2,076 vs. €2,473, being €2,032 vs. €2,237 after adjusting by corresponding HCP, for CAB + RPV LA vs. daily oral ART.

CONCLUSIONS

These results suggest that the implementation of CAB + RPV LA in NHS hospitals would not incur in increased HRU-related costs compared to current daily oral ARTs, being potentially neutral or even cost-saving.

摘要

介绍

目前,HIV 的治疗方法包括每日口服抗逆转录病毒疗法(ART)。卡替拉韦 + 利匹韦林长效制剂(CAB+RPV LA)是西班牙首个每 2 个月通过专业医护人员肌内注射给药的可用的 ART。本分析的目的是评估在国家卫生系统(NHS)医院实施 CAB+RPV LA 与每日口服 ART 的潜在医疗资源使用(HRU)和成本影响。

方法

进行了在线定量访谈和成本分析。传染病专家(IDS)、医院药剂师(HP)和护士被问及他们对 CAB+RPV LA 与每日口服 ART 之间 HRU 差异的看法,以及其他感兴趣的概念。将西班牙官方费率应用于 HRU 估计(€2022)的单位成本。

结果

120 名应答者(n=40 名 IDS、n=40 名 HP、n=40 名护士)估计,根据专科(IDS、HP 和护士),每个患者每年的平均就诊次数分别为 3.3 次与 3.7 次;4.4 次与 6.2 次;6.1 次与 3.9 次,CAB+RPV LA 与每日口服 ART 相比;3.0 次与 3.2 次;4.8 次与 5.8 次;6.9 次与 4.9 次,分别为相应专科应答的调整值。总样本的估计导致每位患者的年总成本为€2076 与€2473,CAB+RPV LA 与每日口服 ART 分别为€2032 与€2237,经相应的医护人员调整后。

结论

这些结果表明,与目前的每日口服 ART 相比,在 NHS 医院实施 CAB+RPV LA 不会导致与 HRU 相关的成本增加,可能是中性的,甚至具有成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f6/11297627/f02010e46cb6/12879_2024_9595_Fig1_HTML.jpg

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