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

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.

Keywords: Antiretroviral agents; Cabotegravir; Costs and cost analysis; HIV; Healthcare resource use; Long-acting injectable; Rilpivirine.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Oral
  • Anti-HIV Agents* / administration & dosage
  • Anti-HIV Agents* / economics
  • Anti-HIV Agents* / therapeutic use
  • Diketopiperazines
  • HIV Infections* / drug therapy
  • HIV Infections* / economics
  • Health Care Costs / statistics & numerical data
  • Health Resources / economics
  • Health Resources / statistics & numerical data
  • Humans
  • Injections, Intramuscular
  • Pyridones* / administration & dosage
  • Pyridones* / economics
  • Pyridones* / therapeutic use
  • Rilpivirine* / administration & dosage
  • Rilpivirine* / economics
  • Rilpivirine* / therapeutic use
  • Spain

Substances

  • Rilpivirine
  • Anti-HIV Agents
  • cabotegravir
  • Pyridones
  • Diketopiperazines