Antiretroviral utilization and adherence before versus after expansion of a provincial drug insurance policy
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View abstract on PubMed
Summary
This summary is machine-generated.Antiretroviral Therapy (ART) coverage expansion increased ART utilization and claims but did not significantly improve adherence rates. Further HIV management strategies are needed.
Area Of Science
- Public Health
- Health Services Research
- Pharmacoeconomics
Background
- Drug coverage programs are crucial for managing chronic conditions like HIV/AIDS.
- Evaluating the impact of policy changes on medication access and adherence is essential for optimizing patient outcomes.
- Understanding trends in Antiretroviral Therapy (ART) utilization and adherence is key to effective HIV/AIDS management.
Purpose Of The Study
- To compare Antiretroviral Therapy (ART) utilization and adherence before and after the expansion of a drug coverage program.
- To assess the impact of expanded drug coverage on the number of active ART users, ART claims, and ART spending.
- To evaluate changes in the likelihood of achieving optimal ART adherence (≥95% Proportion of Days Covered [PDC]) post-coverage expansion.
Main Methods
- Retrospective study using administrative databases in Saskatchewan, Canada (1999-2021).
- Interrupted time series analysis to examine trends in ART utilization and spending before and after coverage expansion in 2018.
- Random-effects logistic regression to compare the likelihood of achieving ≥95% PDC pre- and post-coverage expansion, controlling for confounders.
Main Results
- Statistically significant increases in active ART users and ART claims were observed within four months of coverage expansion.
- ART spending increased post-expansion, but this was offset by decreases in prior years.
- No statistically significant difference was found in the likelihood of achieving ≥95% PDC between the pre- and post-coverage periods (adjusted OR 1.26, p=0.423).
Conclusions
- ART coverage expansion successfully increased ART utilization and the number of active users.
- Despite increased utilization, the expansion did not lead to a statistically significant improvement in optimal ART adherence.
- Continued focus on addressing remaining gaps in HIV management is necessary to improve patient outcomes.
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