Cost analysis associated with intramuscular versus oral administration of antiretroviral therapy in the management of human immunodeficiency virus infection

Abstract

Objetive

To identify and analyze the resources and costs associated with the administration of intramuscular antiretroviral therapy (ART) cabotegravir + rilpivirine (CAB + RPV) compared to oral ART in the management of Human Immunodeficiency Virus Type 1 (HIV-1) infection in Spain.

Methods

An economic model was developed to identify resources and analyze costs from the perspective of the National Health System (NHS) and societal, associated with the administration of intramuscular ART (CAB + RPV) compared to oral ART over a two-year time horizon. Costs included treatment change monitoring, pharmaceutical dispensation, administration, management of adverse events to injection-site reactions (AEs-ISR), travel to the hospital, telepharmacy service, and lost work productivity. Unit costs (€, 2023) were obtained from the literature. Sensitivity analyses were conducted to evaluate the robustness of the model.

Results

Intramuscular ART compared to oral ART was associated with an increase in costs of €673.16/patient over two years from the perspective of the NHS, and €719.59/patient from the social perspective. Intramuscular ART would generate increased costs for dispensation (+€97.75), administration (+€394.55), monitoring (+€288.74), management of AEs-ISR (+€6.46), travel (+€8.36), and lost work productivity (+€38.07), compared to oral ART administration.

Conclusion

Treating HIV-1 with intramuscular CAB + RPV leads to increased resource consumption and costs, compared to oral ART.