1ISG-003 Cost saving in antiretroviral therapy through breaking fixed-dose combination and switch to generic formulations

Background The commercialisation of fixed-dose combination meant an improvement in antiretroviral therapy (ART). With generics we have the opportunity to maintain the therapy at a lower cost, but we complicate the dosage regimen again. Purpose To assess the effect in costs of a two-pill, generic-based regimen compared with a branded coformulated regimen, and to project the potential annual savings in the first year of a switch to generic-based ART. We replaced Triumeq ® (ABC/3TC/DTG) by a combination of Tivicay ® (DTG) +generic ABC/3TC, and Atripla ® (TDF/FTC/EFV) by Truvada ® (TDF/FTC)+generic EFV. Material and methods We selected and analysed all patients who received Atripla ® (TDF/FTC/EFV) and Triumeq ® (ABC/3TC/DTG) from June 2016 to September 2017. Data were collected from the medication consumption files of the institution. We analysed the records related to the treatment. The economic savings associated with the change of treatment were quantified. Results 313 patients were analysed, 108 (34.5%) initially treated with Atripla ® and 205 (65%) initially treated with Triumeq ® . A total of 252 (80.5%) patients were switched to a new treatment (162 patients with Triumeq ® and 90 patients whith Atripla ® ), four (1,27%) of whom returned to initial treatment for adverse effects. A total of 61 patients were not changed. The main reason for opposing the change was the difficulty in adherence 17 (27.8%), followed by patient refusal four (6.5%) The change to Triumeq ® meant a saving of €22.380/month and the change to Atripla ® a saving of €10.100/month. This represents a total saving of €389.772/year. Conclusion Generics formulations in ART is an opportunity to contain pharmaceutical costs in hospitals. Changes in therapy produced a low rate of adverse reactions (1.27%) and a cost saving of €389.772/year. It requires adherence data to be able to affirm that this strategy decreases costs without prejudice to the patient. References and/or Acknowledgements All staff of our pharmacy service No conflict of interest