Analysis of Pharmacy Data Reveals Cost Increase in HIV Medications

There have been significant increases in the cost of antiretroviral therapies (ART) for individual therapies and in the cost of therapy initiation over the past several years.

There have been significant increases in the cost of antiretroviral therapies (ART) for individual therapies and in the cost of therapy initiation over the past several years, according to a study published in the September/October 2012 edition of The American Journal of Pharmacy Benefits entitled, “Trends in the First-Year Utilization Costs of HIV Medications.”

The retrospective, longitudinal study was conducted on prescription claims data from CVS Caremark from July 1, 2006, to June 30, 2012. Participants were required to be eligible for pharmacy benefits for at least 6 months prior to the initial index fill and 12 months after the index fill for ART. Patient outcomes were measured on a yearly basis and included total cost of therapy paid by plans plus member out-of-pocket costs per 1-day supply of medication.

Based on their analyses of historical pharmacy claims, researchers determined that the cost of ARTs increased 26% from $26.48 in 2008 to $33.29 by mid-2012. Although generally, an increase in medication price can usually be explained by inflation, the authors noted that the “increases well outpaced prescription medication’s inflation trend of 16% during the same period.”

The authors of the study predict that the cost of ARTs will continue to be a concern for health plans, especially in light of the nearly 60 drugs currently in development for the treatment of HIV. They also note that drugs to prevent HIV infection, like Truvada (emtricitabine/tenofovir), can cost up to $14,130.00 a year when used as a pre-exposure prophylactic (PrEP). However, “a lifetime treatment cost of an HIV infection can be used as a measure of the value in averting a single infection,” noted the authors, and “a prevention intervention is deemed cost-saving if its cost-effectiveness ratio is less than $379,668.00 per infection averted.”