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在艾滋病毒感染的医疗保险受益者中,抗逆转录病毒疗法转换
Mary J Christoph1, Uche Mordi1, Suying Li2
1Gilead Sciences, Inc., Foster City, CA.
Journal of managed care & specialty pharmacy
|February 26, 2026
概括
在医疗保险中使用比克特格拉维尔/埃姆特里西塔宾/特诺福维尔阿拉芬胺 (B/F/TAF) 的艾滋病毒感染者 (PWH) 经历了较低的抗逆转录病毒疗法 (ART) 转换率. 这一发现甚至与患有精神健康或物质使用障碍的PWH一致,这表明B/F/TAF可能会改善ART持久性.
科学领域:
- 艾滋病毒/艾滋病研究研究
- 药物经济学 药物经济学
- 公共卫生 公共卫生
背景情况:
- 抗逆转录病毒治疗 (ART) 的持续性对于有效的艾滋病毒管理至关重要.
- 在Medicare注册的艾滋病毒感染者往往有并发症,这可能会阻碍治疗的坚持.
- 低于最佳的坚持可以导致艾滋病毒治疗结果较差.
研究的目的:
- 为了比较由医疗保险保险的艾滋病毒感染者 (PWH) 之间转换ART治疗方案的模式.
- 评估不同ART疗法对医疗保险人口治疗持续性的影响.
- 评估与或没有精神健康和/或物质使用障碍的PWH中ART切换模式.
主要方法:
- 使用医疗保险索赔数据 (2017-2022) 的回顾性队列研究.
- 包括18岁以上接受ART治疗的经验丰富的PWH.
- 对比了比克特格拉维尔/埃姆特里西塔宾/特诺福维尔阿拉芬胺 (B/F/TAF),杜洛特格拉维尔/拉米丁 (DTG/3TC),杜洛特格拉维尔/阿巴卡维尔/拉米丁 (DTG/ABC/3TC) 和多片剂方案 (MTRs) 的ART转换率.
- 使用逆概率治疗权重和考克斯比例危险模型.
主要成果:
- 与B/F/TAF相比,启动DTG/3TC,DTG/ABC/3TC和MTR的PWH转换ART的危险比率显著更高 (P < 0.0001).
- 具体来说,MTR显示了切换 (5.37倍) 的最高危险比率.
- 在患有精神健康和/或物质使用障碍的PWH子组中观察到类似的趋势.
结论:
- 与其他方案相比,Medicare保险的PWH启动B/F/TAF的转换ART的风险较低.
- 这种转换风险的降低在整体和精神健康和/或物质使用障碍子组中都被观察到.
- 研究结果支持使用B/F/TAF来潜在地改善Medicare人口中的ART持久性.
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