Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen

Frederik N Engsig; Jan Gerstoft; Marie Helleberg; Lars Nørregaard Nielsen; Gitte Kronborg; Lars R Mathiesen; Niels Obel

doi:10.1097/qai.0000000000000199

Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen

Frederik N Engsig, Jan Gerstoft, Marie Helleberg, Lars Nørregaard Nielsen, Gitte Kronborg, Lars R Mathiesen, Niels Obel

Department of Clinical Medicine

19 Citations (Scopus)

Abstract

BACKGROUND: To assess the impact on virological outcomes of a switch from branded single-tablet regimen (STR) including tenofovir, efavirenz, and emtricitabine (STR-TEE) to generic triple-tablet regimen (TTR), including tenofovir, efavirenz, and lamivudine (TTR-TEL), which was implemented on April 1, 2011 to obtain economic savings.

METHODS AND FINDINGS: From the Capital Region of Denmark (covering two-thirds of the Danish HIV patients), we included combination antiretroviral therapy (cART)-naive patients who administered STR-TEE from April 1, 2010 to March 31, 2011 (n = 111) or TTR-TEL from April 1, 2011 to March 31, 2012 (n = 56) and cART-experienced HIV patients who were on STR-TEE from April 1, 2010 (n = 356) or were switched from STR-TEE to TTR-TEL after April 1, 2011 (n = 512). We estimated the fraction with detectable HIV-RNA, development of the 184V/I resistance mutations, and time to switch of cART. Approximately 96.2% of cART-experienced patients on STR-TEE were shifted to TTR-TEL after April 1, 2011. For the naive STR-TEE and TTR-TEL patients, the fractions with detectable HIV-RNA at week 48 were 7.0% and 8.3% and for the cART experienced 4.0% and 4.4%, respectively. The 184V/I resistance mutation was detected in 1 cART-experienced patient on TTR-TEL with virological failure. The risk of switch to a new cART regimen was slightly increased in the cART-experienced population (difference in 1-year risk: 1.5%; 95% confidence interval: -2.4% to 5.4%).

CONCLUSIONS: In settings comparable with the Danish health care system, the estimated economic savings from a switch from STR-TEE to TTR-TEL can be realized with negligible short-term risk of adverse outcomes.

Original language	English
Journal	Journal of acquired immune deficiency syndromes (1999)
Volume	66
Issue number	4
Pages (from-to)	407-413
Number of pages	7
ISSN	1525-4135
DOIs	https://doi.org/10.1097/qai.0000000000000199
Publication status	Published - 1 Aug 2014

Keywords

Adult
Anti-HIV Agents
CD4 Lymphocyte Count
Denmark
Drug Administration Schedule
Drug Combinations
Female
HIV Infections
Humans
Male
Middle Aged
Treatment Outcome
Viral Load

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1097/qai.0000000000000199

Cite this

Engsig, F. N., Gerstoft, J., Helleberg, M., Nielsen, L. N., Kronborg, G., Mathiesen, L. R., & Obel, N. (2014). Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen. Journal of acquired immune deficiency syndromes (1999), 66(4), 407-413. https://doi.org/10.1097/qai.0000000000000199

Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen. / Engsig, Frederik N; Gerstoft, Jan; Helleberg, Marie et al.
In: Journal of acquired immune deficiency syndromes (1999), Vol. 66, No. 4, 01.08.2014, p. 407-413.

Research output: Contribution to journal › Journal article › Research › peer-review

Engsig, FN, Gerstoft, J, Helleberg, M, Nielsen, LN, Kronborg, G, Mathiesen, LR & Obel, N 2014, 'Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen', Journal of acquired immune deficiency syndromes (1999), vol. 66, no. 4, pp. 407-413. https://doi.org/10.1097/qai.0000000000000199

@article{ba0a6c9151464af38eb5d93b4565ee7a,

title = "Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen",

abstract = "BACKGROUND: To assess the impact on virological outcomes of a switch from branded single-tablet regimen (STR) including tenofovir, efavirenz, and emtricitabine (STR-TEE) to generic triple-tablet regimen (TTR), including tenofovir, efavirenz, and lamivudine (TTR-TEL), which was implemented on April 1, 2011 to obtain economic savings.METHODS AND FINDINGS: From the Capital Region of Denmark (covering two-thirds of the Danish HIV patients), we included combination antiretroviral therapy (cART)-naive patients who administered STR-TEE from April 1, 2010 to March 31, 2011 (n = 111) or TTR-TEL from April 1, 2011 to March 31, 2012 (n = 56) and cART-experienced HIV patients who were on STR-TEE from April 1, 2010 (n = 356) or were switched from STR-TEE to TTR-TEL after April 1, 2011 (n = 512). We estimated the fraction with detectable HIV-RNA, development of the 184V/I resistance mutations, and time to switch of cART. Approximately 96.2% of cART-experienced patients on STR-TEE were shifted to TTR-TEL after April 1, 2011. For the naive STR-TEE and TTR-TEL patients, the fractions with detectable HIV-RNA at week 48 were 7.0% and 8.3% and for the cART experienced 4.0% and 4.4%, respectively. The 184V/I resistance mutation was detected in 1 cART-experienced patient on TTR-TEL with virological failure. The risk of switch to a new cART regimen was slightly increased in the cART-experienced population (difference in 1-year risk: 1.5%; 95% confidence interval: -2.4% to 5.4%).CONCLUSIONS: In settings comparable with the Danish health care system, the estimated economic savings from a switch from STR-TEE to TTR-TEL can be realized with negligible short-term risk of adverse outcomes.",

keywords = "Adult, Anti-HIV Agents, CD4 Lymphocyte Count, Denmark, Drug Administration Schedule, Drug Combinations, Female, HIV Infections, Humans, Male, Middle Aged, Treatment Outcome, Viral Load",

author = "Engsig, {Frederik N} and Jan Gerstoft and Marie Helleberg and Nielsen, {Lars N{\o}rregaard} and Gitte Kronborg and Mathiesen, {Lars R} and Niels Obel",

year = "2014",

month = aug,

day = "1",

doi = "10.1097/qai.0000000000000199",

language = "English",

volume = "66",

pages = "407--413",

journal = "Journal of acquired immune deficiency syndromes (1999)",

issn = "1525-4135",

publisher = "Lippincott Williams & Wilkins",

number = "4",

}

TY - JOUR

T1 - Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen

AU - Engsig, Frederik N

AU - Gerstoft, Jan

AU - Helleberg, Marie

AU - Nielsen, Lars Nørregaard

AU - Kronborg, Gitte

AU - Mathiesen, Lars R

AU - Obel, Niels

PY - 2014/8/1

Y1 - 2014/8/1

N2 - BACKGROUND: To assess the impact on virological outcomes of a switch from branded single-tablet regimen (STR) including tenofovir, efavirenz, and emtricitabine (STR-TEE) to generic triple-tablet regimen (TTR), including tenofovir, efavirenz, and lamivudine (TTR-TEL), which was implemented on April 1, 2011 to obtain economic savings.METHODS AND FINDINGS: From the Capital Region of Denmark (covering two-thirds of the Danish HIV patients), we included combination antiretroviral therapy (cART)-naive patients who administered STR-TEE from April 1, 2010 to March 31, 2011 (n = 111) or TTR-TEL from April 1, 2011 to March 31, 2012 (n = 56) and cART-experienced HIV patients who were on STR-TEE from April 1, 2010 (n = 356) or were switched from STR-TEE to TTR-TEL after April 1, 2011 (n = 512). We estimated the fraction with detectable HIV-RNA, development of the 184V/I resistance mutations, and time to switch of cART. Approximately 96.2% of cART-experienced patients on STR-TEE were shifted to TTR-TEL after April 1, 2011. For the naive STR-TEE and TTR-TEL patients, the fractions with detectable HIV-RNA at week 48 were 7.0% and 8.3% and for the cART experienced 4.0% and 4.4%, respectively. The 184V/I resistance mutation was detected in 1 cART-experienced patient on TTR-TEL with virological failure. The risk of switch to a new cART regimen was slightly increased in the cART-experienced population (difference in 1-year risk: 1.5%; 95% confidence interval: -2.4% to 5.4%).CONCLUSIONS: In settings comparable with the Danish health care system, the estimated economic savings from a switch from STR-TEE to TTR-TEL can be realized with negligible short-term risk of adverse outcomes.

AB - BACKGROUND: To assess the impact on virological outcomes of a switch from branded single-tablet regimen (STR) including tenofovir, efavirenz, and emtricitabine (STR-TEE) to generic triple-tablet regimen (TTR), including tenofovir, efavirenz, and lamivudine (TTR-TEL), which was implemented on April 1, 2011 to obtain economic savings.METHODS AND FINDINGS: From the Capital Region of Denmark (covering two-thirds of the Danish HIV patients), we included combination antiretroviral therapy (cART)-naive patients who administered STR-TEE from April 1, 2010 to March 31, 2011 (n = 111) or TTR-TEL from April 1, 2011 to March 31, 2012 (n = 56) and cART-experienced HIV patients who were on STR-TEE from April 1, 2010 (n = 356) or were switched from STR-TEE to TTR-TEL after April 1, 2011 (n = 512). We estimated the fraction with detectable HIV-RNA, development of the 184V/I resistance mutations, and time to switch of cART. Approximately 96.2% of cART-experienced patients on STR-TEE were shifted to TTR-TEL after April 1, 2011. For the naive STR-TEE and TTR-TEL patients, the fractions with detectable HIV-RNA at week 48 were 7.0% and 8.3% and for the cART experienced 4.0% and 4.4%, respectively. The 184V/I resistance mutation was detected in 1 cART-experienced patient on TTR-TEL with virological failure. The risk of switch to a new cART regimen was slightly increased in the cART-experienced population (difference in 1-year risk: 1.5%; 95% confidence interval: -2.4% to 5.4%).CONCLUSIONS: In settings comparable with the Danish health care system, the estimated economic savings from a switch from STR-TEE to TTR-TEL can be realized with negligible short-term risk of adverse outcomes.

KW - Adult

KW - Anti-HIV Agents

KW - CD4 Lymphocyte Count

KW - Denmark

KW - Drug Administration Schedule

KW - Drug Combinations

KW - Female

KW - HIV Infections

KW - Humans

KW - Male

KW - Middle Aged

KW - Treatment Outcome

KW - Viral Load

U2 - 10.1097/qai.0000000000000199

DO - 10.1097/qai.0000000000000199

M3 - Journal article

C2 - 24984188

SN - 1525-4135

VL - 66

SP - 407

EP - 413

JO - Journal of acquired immune deficiency syndromes (1999)

JF - Journal of acquired immune deficiency syndromes (1999)

IS - 4

ER -

Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this