Pharmacist interventions supported treatment adherence, virologic suppression, and care coordination for people living with HIV (PLWH), according to findings presented at AMCP Nexus 2022.

Combination cabotegravir/rilpivirine (Cabenuva), the first long-acting injectable regimen used to treat HIV-1 in patients who have achieved virologic suppression, was approved in 2021.

For the study, a researcher analyzed pharmacy claims and prior authorization data from Amida Care, a nonprofit Medicaid special needs plan that specializes in providing services to PLWH. Included in the analysis were 41 patients who had a documented prior authorization for cabotegravir/rilpivirine between June 2021 and May 2022.

Medication was dispensed across 22 pharmacies, and pharmacists conducted outreach to 30 providers. Pharmacist-led interventions (n=83) and care coordination were associated with an adherence rate of 100%.

Using Average Wholesale Price, the study author estimated costs per each patient depending on which antiretroviral therapy they received. The projected annual maintenance costs for each regimen were as follows:

• $43,837 for cabotegravir/rilpivirine administered every 2 months;
• $58,449 for cabotegravir/rilpivirine administered monthly;
• $51,606 for elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya);
• $51,606 for bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy);
• $61,811 for darunavir/cobicistat/emtricitabine/tenofovir alafenamide (Symtuza); and
• $48,082 for abacavir/dolutegravir/lamivudine (Triumeq).

“Pharmacist interventions lead to treatment adherence, virologic suppression, and provider coordination” among PLWH, and cabotegravir/rilpivirine administered once every 2 months represented the greatest potential cost savings compared to other antiretroviral therapys, the study author concluded.

Reference:
Milan C. Impact of pharmacist-led interventions to implement long-acting injectable regimen cabotegravir plus rilpivirine for the treatment of HIV-1 and maintain adherence and potential cost savings. J Manage Care Spec Pharm. 2022;28(10-a suppl):S1-S137. doi:10.18553/jmcp.2022.28.10-a.s1