为什么推出长效PrEP药物如此缓慢?
Rupa R Patel1, Kenneth H Mayer2,3
1Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
Current opinion in HIV and AIDS
|December 5, 2024
概括
注射性卡博特格拉维尔用于预防艾滋病毒是有效的,但在全球范围内实施缓慢. 高成本,复杂的采购和人员负担阻碍了其作为长期作用的暴露前预防选择的广泛使用.
科学领域:
- 公共卫生 公共卫生
- 预防传染病 预防传染病
- 药理学 药理学是指药理学的学科.
背景情况:
- 可注射卡博特格拉维尔为预防艾滋病毒提供了一种有效的长期作用的暴露前预防 (PrEP) 选择.
- 这种新型PrEP模式的全球实施尽管已被证明是有效的,但仍面临重大延迟.
研究的目的:
- 审查导致全球缓慢推出可注射卡博特格拉维尔用于艾滋病毒暴露前预防的多方面的因素.
- 确定药物采购,成本和医疗保健系统整合方面的挑战,这些挑战阻碍了广泛采用.
主要方法:
- 全球药物批准和注射性cabotegravir的处方数据的审查.
- 对药物成本,仿制药生产时间表和医疗保健系统资源配置的分析.
- 检查实施科学研究的局限性和临床交付策略.
主要成果:
- 尽管在53个国家获得批准,但注射性卡博特格拉维尔的使用仍然很低,在2023年仅占美国PrEP处方的2.5%,仅占美国PrEP处方的2.5%.
- 在实施研究之外的可用性是有限的,一般版本预计直到2027年才会出现.
- 高昂的成本,复杂的采购途径和管理和患者管理的大量人员需求造成了重大障碍.
结论:
- 注射性卡博特格拉维尔尚未达到其作为替代PrEP策略的潜力,用于与每日药片坚持扎的人.
- 从卡博特格拉维尔的采购和输送中吸取的经验教训对于未来的长效艾滋病毒预防药物至关重要.
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