The Body Covers: The 1st International AIDS Society Conference on HIV Pathogenesis and Treatment
Cost Benefit and Outcomes of HAART
July 9, 2001
Click here to view the original abstract.
So some people in some states have virtually unlimited access to what they need, while others in other states have severely limited access. The authors examined actual data from the Pennsylvania ADAP to evaluate the impact of an open formulary on disease progression and survival compared to a restricted formulary. They specifically looked at the impact of the addition of abacavir and efavirenz to the formulary comparing actual data from Pennsylvania before (November 1998) and after (May 1999) the addition of abacavir and efavirenz.
They utilized data from the Multicenter AIDS Cohort Study (MACS) as well as data from Glaxo Wellcome clinical trials with respect to disease progression/survival in response to antiretroviral regimens. They showed that the average drug cost with an open ADAP formulary was actually slightly lower than with a closed formulary. In addition survival was slightly higher with the open formulary. Cost effectiveness would also be improved with the open formulary.
The likely explanation is that the use of abacavir or efavirenz would foster better adherence to therapy due to the simplicity of regimens containing these agents. Better adherence should translate into an improved response, and improved antiviral response would mean improved survival and delayed disease progression. And, aside from the obvious benefits of delayed disease progression and improved survival, would come lower costs. Multiple prior studies have shown that each of these consequences is predictable. Everyone benefits from greater access to antiretrovirals, not just those infected with HIV but also the entire health care system because of reduced complications, hospitalizations and so forth. So, we need to attempt to keep ADAP formularies as open as possible and accessible for all that qualify.
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