People living with HIV/AIDS, as well as those working in the field, policymakers, and others committed to ending the epidemic will meet next week in Washington D.C. for the XIX International AIDS Conference.
Over the past year, the United States has experienced rapid growth in drug spend to treat HIV, which now ranks #4 among specialty therapy classes in total drug spend. After a 5% increase in 2011, total spending is expected to climb another 23% over the next three years.
The Per Member Per Year (PMPY) cost is the annual HIV drug spend divided by the entire commercially insured population. While this PMPY figure was a modest-sounding $18.08 in 2011, the average cost for a single HIV prescription was $894.33.
The estimated 1.2 million Americans currently living with HIV experience this burden as they manage their disease.
Progress in Treatment
Great advances have been made in the treatment of HIV since it was first identified in the 1980s. Multi-drug, antiretroviral therapies have substantially reduced AIDS deaths from a peak of approximately 50,000 in 1995 to 17,774 in 2009 according to the Centers for Disease Control and Prevention (CDC). However, 50,000 new cases occur each year, and as many as 20% of Americans currently living with HIV are unaware of their condition.
Continued Adherence Challenges
With effective treatment, HIV antibodies can fall to undetectable levels. Still, nearly one in four HIV patients are nonadherent to their drug therapy, which severely reduces the benefit of the medications. Continuing care from a physician is also necessary to monitor the complex medication regiments and serious side effects from the HIV drugs. A recent CDC study found that 41% of HIV patients are not under a physician’s care, again reducing adherence.
Future of HIV Treatment: Specialty Pharmacy
Fortunately, utilization of HIV medications is expected to increase with expanded screening, increased diagnosis and longer life expectancy for patients. Research by the Lewin Group found that specialty pharmacy services, such as those provided by CuraScript, increased overall adherence and improved clinical outcomes. Patients on average exhibited a 38% increase in CD4 cell count within six months – a sign of improved immune system function. The study also showed a $3,000 annual per patient savings in health care costs for those patients receiving their medications through a specialty pharmacy.
Later this week, we’ll discuss CuraScript’s specific services to support HIV patients.