使用覆盖日数比例的药物坚持与在艾滋病毒感染者中实现病毒抑制之间的相关性
Mary Komandt1, Scott Canfield2, Matthew Lengel2
1Indiana University Health Specialty Pharmacy, Plainfield.
Journal of managed care & specialty pharmacy
|September 30, 2023
概括
将艾滋病毒治疗的坚持值从90%降至75%可以保持病毒抑制率. 这一发现表明,付款人可以重新评估针对艾滋病毒患者的药房绩效指标.
科学领域:
- 传染性疾病 传染性疾病
- 药物经济学 药物经济学
- 公共卫生 公共卫生
背景情况:
- 药物坚持对于HIV治疗成功和病毒抑制至关重要.
- 目前的指导方针建议至少遵守90%,但较低的比例可能足够.
- 付款人越来越多地使用合规率来评估药店的表现.
研究的目的:
- 为了确定与较低的PDC水平相比,至少90%的覆盖日 (PDC) 是否必要用于病毒抑制.
- 调查人口因素对艾滋病毒患者病毒抑制的影响.
主要方法:
- 在2020年7月至2021年6月期间,对1,629名成年艾滋病毒患者进行了回顾性观察性研究,这些患者服用了抗逆转录病毒药物,并记录了病毒载量.
- 在通用产品标识符 (GPI) 层面计算PDC的加权平均值.
- 使用后勤回归来分析PDC,人口因素和病毒抑制之间的相关性.
主要成果:
- 总体病毒抑制率为93.1% (1,516名患者).
- 在PDC降至75%以下之前,病毒抑制没有显著差异.
- 患有PDC<75%的患者比患有PDC≥90% (P<0.001) 的患者更不可能实现病毒抑制.
结论:
- 坚持率高于75%的HIV患者获得的病毒抑制结果与90%以上的患者相美.
- 高种群病毒抑制可能是可以实现的,只有39.2%的患者遇到PDC> 90%.
- 指导实体应该考虑降低90%的遵守门,并完善付款人的绩效指标.
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