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. 2023 Feb;32(2):531-541.
doi: 10.1007/s11136-022-03290-0. Epub 2022 Dec 13.

Patient preferences and health state utilities associated with the treatment process of antiretroviral therapy for people living with HIV

Louis S Matza  1 , Timothy A Howell  2 , Vasiliki Chounta  3 , Nicolas van de Velde  4
Affiliations

Patient preferences and health state utilities associated with the treatment process of antiretroviral therapy for people living with HIV

Louis S Matza et al. Qual Life Res. 2023 Feb.

Abstract

Purpose: People living with HIV (PLHIV) have reported challenges associated with daily oral antiretroviral therapy (ART), including missed doses, negative psychological impact, and difficulty remaining discreet while at home or traveling. Recently approved long-acting injectable (LAI) ART may help eliminate these concerns. The purpose of this study was to examine patient preferences and estimate health state utilities associated with oral and LAI treatment for ART.

Methods: Four health state vignettes were developed based on published literature, clinician interviews, and a pilot study. All vignettes included the same description of HIV, but differed in treatment regimens: (A) single daily oral tablet, (B) two daily oral tablets, (C) injections once monthly, and (D) injections every two months. PLHIV in the UK reported their preferences and valued the health states in time trade-off utility interviews.

Results: The sample included 201 PLHIV (83.1% male; mean age = 44.9y). The health states frequently selected as most preferable were D (n = 119; 59.2%) and A (n = 75; 37.3%). Utility differences among health states were relatively small, which is typical for treatment process utilities (mean utilities: A, 0.908; B, 0.905; C, 0.900; D, 0.910). Statistically significant differences in utility were found for one vs. two tablets and injections every month vs. every two months (p < 0.001). Participants' quotations highlight the wide range of reasons for treatment process preferences.

Conclusions: Current results indicate that many PLHIV would prefer LAI ART. The reported utilities may be useful in economic modeling comparing oral vs. LAI ART.

Keywords: Antiretroviral therapy; HIV; Health state utility; Long-acting injectable; Route of administration; Treatment process utility; Utility.

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Conflict of interest statement

LM and TH are employed by Evidera, a company that received funding from ViiV for time spent conducting this study. VC is employed by ViiV, and NVdV was employed by ViiV at the time this study was conducted. Both VC and NVdV own stock in ViiV.

Figures

Fig. 1
Fig. 1
Mean Health State Utilitiesa (N = 201). a TTO health state utilities are on a scale anchored with 0 representing dead and 1 representing full health. b The error bars represent the 95% confidence intervals for health state utilities: A, 0.892—0.925; B, 0.888—0.922; C, 0.884—0.917; D, 0.894—0.926
See this image and copyright information in PMC

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