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Pharmacist Interventions Improve HIV Outcomes, Provider Coordination
Pharmacist interventions supported treatment adherence, virologic suppression, and care coordination for people living with HIV (PLWH), according to findings presented at AMCP Nexus 2022.
Combination cabotegravir/rilpivirine (Cabenuva), the first long-acting injectable regimen used to treat HIV-1 in patients who have achieved virologic suppression, was approved in 2021.
For the study, a researcher analyzed pharmacy claims and prior authorization data from Amida Care, a nonprofit Medicaid special needs plan that specializes in providing services to PLWH. Included in the analysis were 41 patients who had a documented prior authorization for cabotegravir/rilpivirine between June 2021 and May 2022.
Medication was dispensed across 22 pharmacies, and pharmacists conducted outreach to 30 providers. Pharmacist-led interventions (n=83) and care coordination were associated with an adherence rate of 100%.
Using Average Wholesale Price, the study author estimated costs per each patient depending on which antiretroviral therapy they received. The projected annual maintenance costs for each regimen were as follows:
- $43,837 for cabotegravir/rilpivirine administered every 2 months;
- $58,449 for cabotegravir/rilpivirine administered monthly;
- $51,606 for elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya);
- $51,606 for bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy);
- $61,811 for darunavir/cobicistat/emtricitabine/tenofovir alafenamide (Symtuza); and
- $48,082 for abacavir/dolutegravir/lamivudine (Triumeq).
“Pharmacist interventions lead to treatment adherence, virologic suppression, and provider coordination” among PLWH, and cabotegravir/rilpivirine administered once every 2 months represented the greatest potential cost savings compared to other antiretroviral therapys, the study author concluded.
Reference:
Milan C. Impact of pharmacist-led interventions to implement long-acting injectable regimen cabotegravir plus rilpivirine for the treatment of HIV-1 and maintain adherence and potential cost savings. J Manage Care Spec Pharm. 2022;28(10-a suppl):S1-S137. doi:10.18553/jmcp.2022.28.10-a.s1