Evidence map›Paper›PMID 37081570›Full record

ArticleJournal of pharmaceutical policy and practice2023

Access to a novel first-line single-tablet HIV antiretroviral regimen in Affordable Care Act Marketplace plans, 2018-2020.

Rohan Khazanchi, Samuel Powers, Amy Killelea, Andrew Strumpf, Tim Horn, Auntré Hamp, Kathleen A McManus

Abstract read
In one paragraph

Article in Journal of pharmaceutical policy and practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rohan KhazanchiCollege of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.ORCID http://orcid.org/0000-0003-2230-0517
Samuel PowersDivision of Infectious Diseases and International Health, Department of Medicine, University of Virginia, P.O. Box 801379, Charlottesville, VA, 22908, USA.
Amy KilleleaHealth Systems and Policy, National Alliance of State and Territorial AIDS Directors (NASTAD), Washington, DC, USA.
Andrew StrumpfDivision of Infectious Diseases and International Health, Department of Medicine, University of Virginia, P.O. Box 801379, Charlottesville, VA, 22908, USA.
Tim HornHealth Systems and Policy, National Alliance of State and Territorial AIDS Directors (NASTAD), Washington, DC, USA.
Auntré HampHealth Systems and Policy, National Alliance of State and Territorial AIDS Directors (NASTAD), Washington, DC, USA.
Kathleen A McManusDivision of Infectious Diseases and International Health, Department of Medicine, University of Virginia, P.O. Box 801379, Charlottesville, VA, 22908, USA. km8jr@uvahealth.org.ORCID http://orcid.org/0000-0001-5786-0018

Funding

Deconstructing HIV Disparities: Multistate Study of Data, Outcomes and MediatorsK08AI136644 · NIAID · UNIVERSITY OF VIRGINIA · PI MCMANUS, KATHLEEN ANN · 2018 to 2022
$1.0M
NIAID NIH HHS K08 AI136644
6 · The paper itself

Abstract

backgroundA pillar of the United States' Ending the HIV Epidemic (EHE) initiative is to rapidly provide antiretroviral therapy (ART) in order to achieve HIV viral suppression. However, insurance benefit design can impede ART access. The primary objective of this study is to understand how Affordable Care Act (ACA) Marketplace qualified health plan (QHP) formularies responded to two new ART single tablet regimens (STRs): dolutegravir/abacavir/lamivudine (DTG/ABC/3TC; approved in 2014) and bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF; approved in 2018).

methodsWe conducted a descriptive study of individual and small group QHPs to assess coverage, cost sharing (coinsurance vs. copay), specialty tiering, prior authorization, and out-of-pocket (OOP) costs for DTG/ABC/3TC and BIC/FTC/TAF. All individual and small group QHPs offered in state ACA Marketplaces from 2018-2020 were identified using plan-level formulary data from Ideon linked to end-of-year data from Robert Wood Johnson Foundation's Individual Market Health Insurance Exchange (HIX).

resultsFor 2018, 2019, and 2020, respectively, we identified 19,533, 17,007, and 21,547 QHPs. While DTG/ABC/3TC coverage was above 91% from 2018-2020, BIC/FTC/TAF coverage improved from 60 to 86%. Coverage of BIC/FTC/TAF improved in EHE priority jurisdictions from 73 to 90% driven by increased coverage with coinsurance. Although BIC/FTC/TAF had a higher wholesale acquisition cost than DTG/ABC/3TC, monthly OOP cost trends differed regionally in the Midwest but did not differ by EHE priority jurisdiction status.

conclusionsQHP coverage of STRs is heterogeneous across the US. While coverage of BIC/FTC/TAF increased over time, many QHPs in EHE priority jurisdictions required coinsurance. Access to new ART regimens may be slowed by delayed QHP coverage and benefit design.

Indexed as

Access to careCoinsuranceCopayCostCoverageDrug pricingHIVPharmacoequity

Identifiers

PMID37081570
PMCPMC10116786

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.