Multi-Indication Pricing: Pros, Cons, And Its Applicability To The United Kingdom

Abstract

Objectives: This study aims to determine whether patients receiving antiretroviral prescription medications to treat HIV/AIDS through a 340B program exhibited differences in medication adherence rates as compared to comparable patients whose medications were not received through a 340B program. MethOds: Using data from Walgreens, 2008 -2014, we conducted a retrospective propensity matched cohort study comparing medication adherence rates for a national sample of HIV/ AIDS patients who received medications through a 340B program to a matched cohort of HIV/AIDS patients whose antiretroviral medications were not received through a 340B program. Patients were matched by age, gender, initial dispensing year, length of HIV therapy, length of medication therapy, and 91 therapeutic classes. Adherence to antiretroviral medications was measured using the proportion of days covered (PDC) metric. One-to-one matching resulted in 9,437 matched pairs. We used mixed modelling methods to assess statistical differences. Results: Mean PDC was higher for the 340B cohort versus the comparison cohort (84% vs. 77%, p< .001). Forty-five percent of the 340B cohort had medication adherence rates (PDC) greater than or equal to the 95% adherence threshold for HIV/AIDS patients compared to the comparison cohort where 41% of patients were adherent according to this threshold (p< .001). cOnclusiOns: These results show that patients with HIV/AIDS who receive antiretroviral medications through a 340B program had higher medication adherence rates, which have been associated with better clinical outcomes. Various factors, such as lower patient costs or improved access to pharmacies, may impact patient adherence, and we will explore such factors on adherence in future research on the 340B Program.

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