EACS2023: 876 Evolution of patterns and cost of antiretroviral strategies over 8 years among people living with HIV (PHIV): experience of PitiéSalpêtrière HIV clinical center in France L. Sagaon-Teyssier , M.-A. Valantin , A. Fauchois , R. Tubiana , S. Seang , L. Schneider , R. Palich , A. Fayçal , R. Agher , C. Katlama Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France, Sorbonne University, Infectious Diseases Department APHP Hôpital Pitié salpetriere, Pierre Louis Epidemiology and public health institute (IPLESP) INSERM 1136, Paris, France General data Abstract category: Access and delivery of care Abstract body Purpose: To study the evolution of antiretroviral treatment strategies (ARTs) and associated costs over 8 years. Method: This observational study included patients on 3-drug or 2-drug-daily-regimen (3-DRs, 2DRs) with a yearly follow-up between January-2015 (baseline) and December-2022. Data were obtained from the NADIS® record system and costs from National French records. Drug-reduced regimens (D-Red-ART) included 2-DR or intermittent ART (i-ART, 4 or 5-days/week). Sequence analysis was used to identify evolution of ART. Logistic regression estimated factors associated to D-Red-ART. Results: 2288 patients were analyzed: 65.9% men; 50.6% born in France (BF) and 32.9% in Sub-Saharan Africa; median age: 50.6 IQR[43.2-57.1] years; ART duration: 12.9[6.3-18.7] years, viral suppression (VS) rate 95.2% and VS duration: 5.9[2.89.8] years. Over the 8-year period, 1320 (57.7%) patients kept baseline strategy (3-DR: 1013; 2-DR: 307). D-Red-ART concerned 845/2288 (36.9%) patients: 422 switched to 2-DR and 423 to i-ART. (Figure 1a/1b). No deleterious effect was observed in VS for D-Red-ART (Figure 2a/2c). Patients BF (aOR:1.46, 95%CI[1.13-1.91]), with long-term VS (aOR:1.05, 95%CI[1.03-1.08] per year), and followed by full-time HIV professionals (aOR:1.79, 95%CI[1.48-2.16]) were more likely to switch to D-Red-ART. Over 8 years, costs of HIV care decreased from 30.8M€ in 2015 to 15.9M€ in 2022. i-ART lead to substantial cost reduction: -50.2% between 2015 and 2022 (compared to -46.8% for both 3-DR and 2-DR). 3-DR-intermittent strategy provided the highest cost reduction (-65% versus -59% for 2-DR-intermittent, Figure 2b/2d). Cost reductions were not associated with differences in terms of frequency of medical visits and viral load (VL) measurements: respectively 27(±14) visits and 19(±6) measurements over the period (p=0.945). Conclusions: Over 8 years, 36.9% of patients switched to D-Red-ART. Savings represented 122M€, with no increased charges in terms of visits and VL assessment. These strategies, safe, cost-effective should be investigated more largely world-wide including the assessment of patients' psychosocial benefits. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1 2 2 2 2 2 2 2 2 2 1 2 52 19TH EUROPEAN AIDS CONFERENCE | WARSAW 2023
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