Healthcare Resource Consumption and Related Costs in Patients on Antiretroviral Therapies: Findings from Real-World Data in Italy

Valentina Perrone, Melania Dovizio, Diego Sangiorgi, Margherita Andretta, Fausto Bartolini, Arturo Cavaliere, Andrea Ciaccia, Alessandro Chinellato, Alberto Costantini, Stefania Dell’Orco, Fulvio Ferrante, Simona Gentile, Antonella Lavalle, Rossella Moscogiuri, Elena Mosele, Cataldo Procacci, Davide Re, Fiorenzo Santoleri, Alessandro Roccia, Franco Maggiolo and Luca Degli Esposti ()
Additional contact information
Valentina Perrone: CliCon S.r.l. Società Benefit—Health, Economics & Outcomes Research, 40137 Bologna, Italy
Melania Dovizio: CliCon S.r.l. Società Benefit—Health, Economics & Outcomes Research, 40137 Bologna, Italy
Diego Sangiorgi: CliCon S.r.l. Società Benefit—Health, Economics & Outcomes Research, 40137 Bologna, Italy
Margherita Andretta: Azienda ULSS 8 Berica, 36100 Vicenza, Italy
Fausto Bartolini: USL Umbria 2 Terni, 05100 Terni, Italy
Arturo Cavaliere: ASL Viterbo, 01100 Viterbo, Italy
Andrea Ciaccia: Servizio Farmaceutico Territoriale ASL Foggia, 71121 Foggia, Italy
Alessandro Chinellato: Azienda ULSS 3 Serenissima, 30174 Mestre, Italy
Alberto Costantini: ASL Pescara, 65100 Pescara, Italy
Stefania Dell’Orco: ASL Roma 6, 00041 Albano Laziale, Italy
Fulvio Ferrante: ASL Frosinone, 03100 Frosinone, Italy
Simona Gentile: Direzione Generale per la Salute Regione Molise, 86100 Campobasso, Italy
Antonella Lavalle: Direzione Generale per la Salute Regione Molise, 86100 Campobasso, Italy
Rossella Moscogiuri: ASL Taranto, 74121 Taranto, Italy
Elena Mosele: UOC Assistenza Farmaceutica Territoriale, Azienda ULSS 7 Pedemontana, 36061 Bassano del Grappa, Italy
Cataldo Procacci: Dipartimento Farmaceutico ASL BAT, 76125 Trani, Italy
Davide Re: ASL Teramo, 64100 Teramo, Italy
Fiorenzo Santoleri: ASL Pescara, 65100 Pescara, Italy
Alessandro Roccia: Gilead Sciences S.r.l., 20124 Milano, Italy
Franco Maggiolo: ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
Luca Degli Esposti: CliCon S.r.l. Società Benefit—Health, Economics & Outcomes Research, 40137 Bologna, Italy

IJERPH, 2023, vol. 20, issue 5, 1-12

Abstract: This real-world analysis conducted on administrative databases of a sample of Italian healthcare entities was aimed at describing the role of therapeutic pathways and drug utilization in terms of adherence, persistence, and therapy discontinuation in HIV-infected patients under antiretroviral therapies (ART) and Tenofovir Alafenamide (TAF)-based regimens on healthcare resource consumption and related direct healthcare costs. Between 2015 and 2019, adults (≥18 years) prescribed with TAF-based therapies were identified and characterized in the year prior to the first prescription (index-date) for TAF-based therapies and followed-up until the end of data availability. Overall, 2658 ART-treated patients were included, 1198 of which were under a TAF-based regimen. TAF-based therapies were associated with elevated percentages of adherence (83.3% patients with proportion of days covered, PDC > 95% and 90.6% with PDC > 85%) and persistence (78.5%). The discontinuation rate was low in TAF-treated patients, ranging from 3.3% in TAF-switchers to 5% in naïve. Persistent patients had lower overall mean annual healthcare expenditures (EUR 11,106 in persistent vs. EUR 12,380 in non-persistent, p = 0.005), and this trend was statistically significant also for costs related to HIV hospitalizations. These findings suggest that a better therapeutic management of HIV infection might result in positive clinical and economic outcomes.

Keywords: antiretroviral therapies (ART); human immunodeficiency virus (HIV); tenofovir alafenamide (TAF)-based regimens; drug utilization; adherence; persistence; healthcare resource consumption; direct healthcare costs; real-word evidence (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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