Problem: A regional UK commissioning decision in 2010 mandated that when the component drugs of Combivir—a combination therapy for HIV—come off patent, doctors must prescribe the individual drugs instead. This was driven by a perception that the generic component drugs are cheaper in the immediate-term and so more efficient overall. As our pharmaceutical client’s HIV combination drug was soon to come off patent, they wanted to help commissioners understand the full healthcare costs of such a policy, to inform future decisions.
Approach: We worked with our client and clinicians in Nottingham University Hospital’s HIV clinic who had patient-level care data before and after the commissioning change. We planned the analysis and identified which costs would be used and which data were required.
Impact: Our work contributes to the evidence-base of the costs of prescribing patients a single dose therapy over multiple doses. It has changed people’s perceptions of the costs of treating long-term conditions with combination drugs, and helped commissioners to make policy decisions about mandating use of particular drugs without taking a holistic view of healthcare.
“Aquarius provided a professional yet personal level of support with our project. We found the statistical support invaluable, and felt that they went the extra mile to ensure the project went smoothly and on time.”
- Dr Ruth Taylor, Consultant in Genitourinary Medicine, Nottingham University Hospitals NHS Trust
Taylor R, Carlin E, Sadique Z, Ahmed I, Adams EJ. The financial and service implications of splitting fixed-dose antiretroviral drugs – a case study. Accepted Mar 2014, Int J STD AIDS