In recent years, the wholesale cost of the antiretrovirals (ARVs) recommended as the first choice for people starting HIV treatment has increased much faster than inflation, Healio reports. This is concerning, as studies have indicated that the wholesale cost of prescription drugs is associated with lower adherence to medication regimens.
One such recent study found that about 1 in 15 people with HIV skip doses of any of the medications they take (including non-ARVs) to save money.
Rochelle P. Walensky, MD, MPH, a professor of medicine at Harvard Medical School, led the new analysis on ARV costs. Publishing their findings in JAMA Internal Medicine, she and her colleagues analyzed data on the average wholesale price of ARVs according to the Department of Health and Human Services’ annual update of the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents, specifically the 2012 to 2018 period.
The annual wholesale prices of the ARV regimens recommended as first-line options ranged from $24,970 to $35,160 in 2012. By 2018, this range had increased to $36,080 to $48,000.
During the study period, the average annual cost of ARVs that were recommended for most people with HIV—meaning those who did not have special considerations such as other health conditions—increased by 34%, or 3.5-fold faster than the rate of inflation.
Between 2012 and 2018, the average annual cost of the recommended first-line ARVs for HIV-positive people with special health considerations was lower than that of ARVs recommended for those people without such considerations, and yet it increased by 53% during that period, or 5.6-fold faster than inflation.
During any particular drug’s time as a recommended first-line treatment for HIV, the average cost increased 2.8-fold to 6.7-fold faster than inflation. After such drugs fell off the list of recommended first-line treatments, the pace of their cost increases rose to 4-fold to 5.7-fold faster than inflation.
Walensky expressed concern to Healio that the high—and quickly increasing cost of ARVs—wind up imposing hardships on people with HIV, given such high costs’ association with higher co-pays, restrictions on which drugs insurers will cover or a total lack of access to the drugs.
Any particular state’s lack of Medicaid expansion under the Affordable Care Act, Walensky said, can also limit access to ARVs for people with HIV. She pointed out that of the various U.S. counties included in the nascent federal plan to ramp up efforts to combat the HIV epidemic, half are in states that did not expand Medicaid.
To read the study abstract, click here.
To read the Healio article, click here.