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. 2021 Nov 26;11(11):e046212.
doi: 10.1136/bmjopen-2020-046212.

Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

Emmanuelle Papot  1   2 , Nikos Kalampalikis  3 , Marjolaine Doumergue  3 , Fabrice Pilorgé  4 , Guillemette Quatremère  4 , Yazdan Yazdanpanah  5   2 , Marie Préau  6 ; ANRS-GOTA study group
Collaborators, Affiliations

Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

Emmanuelle Papot et al. BMJ Open. .

Abstract

Objective: The aim of this study was to evaluate people living with HIV (PLWH) and HIV specialist prescribers' perception of discussing antiretroviral therapy (ART) price in PLWH's care and the acceptability of choosing or switching to various types of less expensive ARTs.

Design: Cross-sectional surveys (one in a convenience sample of PLWH and one in a voluntary response sample of HIV specialist prescribers).

Setting and participants: The surveys were conducted among PLHW attending an HIV clinic in the North of Paris (cohort of 4922 PLWH in 2016), and HIV specialists working in French HIV clinics (210 across 12 districts/28), between January and June 2016.

Method: Self-administered questionnaires were constructed using data collected during focus groups with PLWH and prescribers. Pretests were carried out to select the questions and items. Descriptive analyses of the 129 complete questionnaires of PLWH and 79 of prescribers are presented.

Results: Among PLWH, 128/129 were on ART and 54% (69/128) gave a fair estimation of the price of their current regimen. Among prescribers, 24% (19/79) thought that their patients knew this price. Taking into account the price of ART was not perceived as a negative step in the history of French response to HIV epidemic for 53% (68/129) of PLWH and 82% (65/79) of prescribers. Seventy-seven PLWH (60%) would agree to switch to less expensive antiretroviral regimens (as effective and with similar adverse events) if pills were bigger; 42 (33%) if there were more daily doses, and 37 (29%) if there were more pills per dose; prescribers were more circumspect.

Conclusion: A high proportion of PLWH gave a fair estimate of their ART price and this seemed unexpected by HIV specialists. Consideration of drug prices when choosing ART was perceived as conceivable by PLWH and prescribers if effectiveness and tolerance were also considered.

Keywords: HIV & AIDS; epidemiology; public health.

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Conflict of interest statement

Competing interests: YY received travel grants, honoraria for presentations at workshops and consultancy honoraria from Abbvie, Brystol-Myers Squibb, Gilead, Merck, J&J and ViiV Healthcare.

Figures

Figure 1
Figure 1
Answers from PLWH and prescribers about knowledge of one’s own ART name and price. *‘Fair’ estimation=base price calculated with the regimen reported ±40%. ART, antireroviral therapy; PLWH, people living with HIV.
Figure 2
Figure 2
Answers from PLWH (people living with HIV) and prescribers about the acceptability of switching for economic reasons with different consequences in terms of pill burden. PLWH, people living with HIV.
See this image and copyright information in PMC

References

    1. Cohen MS, McCauley M, Gamble TR. HIV treatment as prevention and HPTN 052. Curr Opin HIV AIDS 2012;7:99–105. 10.1097/COH.0b013e32834f5cf2 - DOI - PMC - PubMed
    1. Bhaskaran K, Hamouda O, Sannes M, et al. . Changes in the risk of death after HIV seroconversion compared with mortality in the general population. JAMA 2008;300:51–9. 10.1001/jama.300.1.51 - DOI - PubMed
    1. Sloan CE, Champenois K, Choisy P, et al. . Newer drugs and earlier treatment: impact on lifetime cost of care for HIV-infected adults. AIDS 2012;26:45–56. 10.1097/QAD.0b013e32834dce6e - DOI - PMC - PubMed
    1. Cnam . Les prescriptions hospitalières de médicaments délivrés en ville en 2016 et les évolutions depuis 2004 [Hospitals' prescriptions of drugs supplied in private pharmacies in 2016 and progression since 2004]. Points de repère n 49 - Les PHMEV en 2016, 2018. Available: https://assurance-maladie.ameli.fr/etudes-et-donnees/2018-phmev-2016-evo...
    1. Chevreul K, Berg Brigham K, Durand-Zaleski I, et al. . France: health system review. Health Syst Transit 2015;17:1–218. - PubMed

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