Examining Drug Trend: HIV

Drug price drove 2016 trend. Overall utilization for the top 10 therapeutic classes in 2016 decreased, while prices increased. To better understand 2016 trend, we will examine the top 10 therapeutic classes and their trend components. Previously we looked at diabetes, inflammatory diseases and oncology and Hepatitis C. Today, we will examine HIV.

State and federal requirements for HIV medication coverage can make utilization management challenging. In 2016, Truvada accounted for 16.5 percent of PMPY spend in HIV, and is currently the only regimen approved for pre-exposure prophylaxis (PrEP). PrEP is a preventive treatment that reduces the likelihood of acquiring HIV for people who do not have HIV, but are at substantial risk of getting it.  One tenofovir alafenamide (TAF) based product, Genvoya, accounted for 7.3 percent of PMPY spend in 2016 in HIV.

In 2015 and 2016, manufacturers introduced several products to the market that effectively replaced older branded products that contained tenofovir disoproxil fumarate (TDF) with new branded products that contain TAF. The manufacturer believes these TAF-based products to have a more favorable safety profile. We anticipate that the use of these TAF-based products will eventually overtake the use of the TDF products. Descovy is a TAF-based regimen similar to Truvada, but is not indicated for PrEP. Although the FDA approved a generic for Truvada in 2017, it is currently unavailable due to ongoing patent litigation. The Department of Human and Health Services updated the HIV guidelines in 2016 that emphasized preferred regimens that contain integrase inhibitors. Utilization of these products will continue to increase. The FDA will review multiple products for HIV in 2018 that will include a vaccine and a two-drug regimen that may change the treatment landscape.

See our 2016 Annual Trend Report to learn more about trend drivers and forecasts for the top therapeutic classes. Make sure to check MedConnect for more in this series.

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