Citation

Simpson KN, Chen SY, Wu AW, Boulanger L, Chambers R, Nedrow K, Tawadrous M, Pashos CL, Haider S. HIV Med. 2014; 15(8): 488-498.

Copyright

(Copyright © 2014, John Wiley and Sons)

DOI

10.1111/hiv.12145

PMID

unavailable

Abstract

OBJECTIVES: The aim of the study was to assess the incidence and costs of adverse events (AEs) among patients with HIV infection treated with nonnucleoside reverse transcriptase inhibitors (NNRTIs) from the health care system perspective.

METHODS: US medical and pharmacy claims during 2004-2009 were examined to select adult new NNRTI users with HIV infection. The incidence of selected AEs and time to occurrence were assessed during the first year. Episodes of care for each AE were identified using claims associated with AE management. For each AE, a propensity score model was used to match patients with an AE to those without (1:4) based on the propensity of having an AE. Mean total health care costs, AE-associated costs and incremental costs per episode, and annual total health care costs per patient were calculated.

RESULTS: Of the 2548 NNRTI-treated patients, 29.3% experienced AEs. The incidence ranged from 0.4 episodes/1000 person-years for suicide/self-injury to 14.9 episodes/1000 person-years for dizziness, 49.8 episodes/1000 person-years for depression and 150.3 episodes/1000 person-years for lipid disorder. The mean AE-associated cost (duration) per episode ranged from $586 (88 days) for lipid disorder to $975 (33 days) for rash, $2760 (73 days) for sleep-related symptoms and $4434 (41 days) for nausea/vomiting. The mean incremental cost per episode ranged from $1580 for rash to $2032 for lipid disorder, $8307 for sleep-related symptoms and $12833 for nausea/vomiting. During the 12 months following NNRTI initiation, the mean annual total health care cost was $27299 (efavirenz: $26185; other NNRTIs: $34993) and AE-associated costs were $608 (efavirenz: $554; other NNRTIs: $979) among all NNRTI users.

CONCLUSIONS: With treatment increasing patient survival, comparisons of therapeutic regimens should consider treatment-associated AEs.

FINDINGS from this study could be informative for clinicians and payers in managing HIV infection with NNRTIs. © 2014 British HIV Association.

Language: en

Keywords

Humans; United States; adolescent; Adult; Aged; Female; Male; Middle Aged; adult; human; Adolescent; Incidence; suicide; female; male; Young Adult; Aged, 80 and over; aged; incidence; depression; HIV; Health Care Costs; Adverse events; Drug-Related Side Effects and Adverse Reactions; article; major clinical study; vomiting; retrospective study; automutilation; Human immunodeficiency virus infection; priority journal; headache; middle aged; anxiety disorder; sleep disorder; economics; efavirenz; HIV Infections; Reverse Transcriptase Inhibitors; RNA directed DNA polymerase inhibitor; health care cost; drug cost; diarrhea; nausea; rash; cohort analysis; liver toxicity; health care system; delavirdine; nevirapine; dizziness; Human immunodeficiency virus infected patient; disorders of lipid and lipoprotein metabolism; young adult; adverse outcome; antiviral therapy; etravirine; very elderly; nonnucleoside reverse transcriptase inhibitor; Health care costs; Nonnucleoside reverse transcriptase inhibitors