[Analysis of adherence and efficiency when replacing an antiretroviral therapy with efavirenz-emtricitabine-tenofovir in a single daily dose]

Farm Hosp. 2012 Sep-Oct;36(5):315-20. doi: 10.1016/j.farma.2011.03.006. Epub 2012 Jul 31.
[Article in Spanish]

Abstract

Objective: To analyse whether the change of antiretroviral therapy to efavirenz/emtricitabine/tenofovir in a single daily dose (EETu) increases adherence and maintains effectiveness, and establish the cost increase caused by the change.

Methods: An observational, retrospective, and intra-subject study, performed in the outpatient dispensing unit. The study period was 1 year (6 months before and 6 months after the change). Computer dispensing records and days of hospitalisation during the study period were reviewed, and the difference in treatment adherence calculated. To determine the effectiveness of treatment, viral load and CD4 lymphocytes data before and after the change were reviewed. The cost before and after treatment for each patient was determined, and therefore the annual cost increase and the incremental cost per patient.

Results: The study included 127 patients. The difference in adherence was 0.6%. The percentage of poor adherence was 35.4% and 40.9% before and after the treatment change, respectively. The levels of CD4 lymphocytes and viral load did not change significantly with treatment. The economic analysis revealed an annual increase of 25,374.60 and €199.80 per patient.

Conclusions: The use of EETu did not improve the control of HIV infection in terms of effectiveness and adherence, and resulted in increased economic costs. Therefore, its choice as antiretroviral treatment will have to be based on criteria other than those described above.

Publication types

  • English Abstract

MeSH terms

  • Adenine / administration & dosage
  • Adenine / adverse effects
  • Adenine / analogs & derivatives*
  • Adenine / therapeutic use
  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / economics
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / economics
  • Antiretroviral Therapy, Highly Active / methods*
  • CD4 Lymphocyte Count
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / adverse effects
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Drug Combinations
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / economics
  • Humans
  • Male
  • Middle Aged
  • Organophosphonates / administration & dosage
  • Organophosphonates / adverse effects
  • Organophosphonates / therapeutic use*
  • Oxazines / administration & dosage
  • Oxazines / adverse effects
  • Oxazines / therapeutic use*
  • Patient Compliance*
  • Spain

Substances

  • Anti-HIV Agents
  • Drug Combinations
  • Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
  • Organophosphonates
  • Oxazines
  • Deoxycytidine
  • Adenine