NPS analysis of HIV medications using MedicineInsight Data
Page last updated: 25 March 2022
Drug utilisation sub-committee (DUSC)
October 2021
Abstract
Purpose
PBAC requested a review of the utilisation of medicines used for the treatment of Human Immunodeficiency Virus (HIV) and for pre-exposure prophylaxis of HIV at its June 2021 meeting. The analyses in this report are for the HIV antiretroviral medicines and are based on general practice data from MedicineInsight.
Data Source / methodology
This study is a descriptive analysis of MedicineInsight data exploring the prescribing of HIV antiretroviral medicines to patients attending general practice. It uses de-identified patient data from the clinical information systems (CIS) of 145 individual practices for the study period 1 (1 January 2018 to 31 December 2019) and 117 individual practices for study period 2 (calendar year 2020).
Key Findings
- This study includes 5.0–5.5% of the approximately 27,500 Australians living with HIV in Australia.
- Patients with diagnosed HIV using antiretroviral medicines were overwhelmingly male (~95%), from higher socioeconomic backgrounds (~62%) and living in major cities (~87%). On average they were aged 50 years.
- Mental illnesses were the most commonly reported co-morbidity. Approximately 40% of patients had a prior or current record of depression and approximately 30% had a prior or current record of anxiety.
- A quarter of patients had been diagnosed with hypertension and 30% had a record of dyslipidaemia.
- Approximately 14% of patients had been diagnosed with both HIV and chronic hepatitis C.
- Even though the majority of patients were males aged in their 50s, 8.7–8.9% of patients had been diagnosed with osteoporosis.
- Fixed dose combination (FDC) antiretroviral medicines were the most commonly prescribed. The FDC bictegravir + tenofovir alafenamide + emtricitabine (Biktarvy) was prescribed for 31.0% of patients and was the most commonly prescribed individual medicine.
- The HIV Protease Inhibitors (HIV-PIs) are associated with increased cardiovascular risk. Among all patients who were prescribed an antiretroviral medicine, the number of patients with recorded cardiovascular disease, at risk of cardiovascular disease or with recorded dyslipidaemia who were prescribed an HIV-PI was 32 (2.1%), 97 (6.4%) and 66 (4.4%), respectively.
- Regimens including rilpivirine or efavirenz should be used in caution in patients with mental illness due to a higher risk of central nervous system side effects. Among all patients who were prescribed an antiretroviral medicine, the number of patients with a prior or current record of mental illness who were prescribed rilpivirine or efavirenz was 116 (7.6%) and 34 (2.2%), respectively.
