Non-ARV Prescriptions and Medication Burden among Commercially Insured U.S. HIV Patients

Accelerated aging and higher co-morbidity prevalence have increased non-antiretroviral (ARV) medications for HIV patients. We examined, over a 12 month period, non-ARV medication burden among HIV-positive patients 18-49 and ≥50 years using a comprehensive U.S. healthcare claims database in an age-and-gender matched analysis (1:3 matching ratio of cases to controls). Primary outcomes of interest included the median and mean number of unique non-ARV drug substances during the one month period with the highest number of prescriptions filled for each individual, and the mean number of unique classes of medication. We identified 9,510 HIV-positive patients aged ≥50 years and 28,530 controls; 15,737 HIV-positive patients aged 18-49 years and 47,211 controls. Sixty percent of HIV-positive patients aged 18-49 years had ≥1 co-morbidities versus 40% of controls; 82% of HIV-positive patients aged ≥50 years had ≥1 co-morbidities versus 66% of controls. Among patients aged 18-49 years, cases were prescribed 5.3 (±4.2) classes of drugs over 12 months; controls were prescribed 4.2 (±3.4) (p 5 drugs versus 19% of controls. Among patients aged ≥50 years, cases were prescribed 7.2 (±5.3) drug classes versus controls [5.6 (±4.4); p 5 medications versus 32% of controls. Overall, HIVpositive patients were more likely to have ≥1 co-morbidities and be prescribed significantly higher numbers of non-ARV unique drugs and drug classes compared to HIV-negative controls.