www.cidrap.umn.edu/hivaids/uptake-l...emains-low-among-medicare-beneficiaries-study
Uptake of long-acting injectable HIV therapy remains low among Medicare beneficiaries, study finds
Laine Bergeson
43 minutes ago.
HIV/AIDS
Researchers found that just 3% of Medicare beneficiaries with HIV were using the injectable treatment in 2023, two years after the Food and Drug Administration approved the sustained viral suppression regimen. The findings also revealed geographic and racial disparities in who received the therapy, mirroring longstanding disparities in access to HIV care.
Use increased over time, but remained low
LA-ART, which combines the drugs cabotegravir and rilpivirine, is administered by injection every four to eight weeks and offers an alternative to taking daily oral antiretroviral medications.
For the study, researchers led by a team at Harvard T.H. Chan School of Public Health analyzed claims data from all Medicare Parts B and D beneficiaries with HIV from 2021 to 2023. They identified nearly 173,000 people with HIV enrolled in Medicare in 2023 and compared those receiving injectable therapy with those taking oral antiretroviral medications.
Use of the injectable regimen increased over time, rising from 638 patients (0.4%) in 2021 to 5,162 patients (3.0%) in 2023. But adoption of long-acting antiretrovirals remained low overall, with 97% of beneficiaries still using oral medications in 2023.
Older adults, rural residents less likely to use LA-ART
Several groups were significantly less likely to use LA-ART.
Compared with people younger than 55 years, adults ages 55 to 64 had a 40% lower [MOU1] [MV2] likelihood of receiving injectable therapy, while those age 65 and older were 60% less likely. American Indian or Alaska Native beneficiaries were almost 50% less likely than White beneficiaries to receive the treatment.
The findings suggest geography may also play a role. People living in rural areas were 27% less likely to receive LA-ART than those in urban areas, and uptake was lower in the South than in other regions of the country.
The findings highlight the need for targeted efforts to reduce cost barriers and improve access to long-acting antiretroviral treatments.
Patients with several chronic conditions, including dementia, chronic kidney disease, heart failure, and stroke, were also less likely to receive LA-ART. The researchers hypothesize that clinicians may be concerned about drug interactions for people with multiple chronic conditions so are less likely to prescribe LA-ART.
In contrast, beneficiaries with mental illness were more likely to receive LA-ART, a finding the researchers call encouraging given adherence challenges in this population.
Beneficiaries who qualified for subsidized drug coverage and those who received financial protections through out-of-pocket maximum caps and reduced cost-sharing were more likely to receive LA-ART, suggesting affordability and type of insurance may influence access.
The findings highlight the need for targeted efforts to reduce cost barriers and improve access to LA-ART among older adults, rural residents, and other underserved populations.
Uptake of long-acting injectable HIV therapy remains low among Medicare beneficiaries, study finds
Laine Bergeson
43 minutes ago.
HIV/AIDS
Despite the promise of freeing people with HIV from taking daily pills, uptake of long-acting injectable antiretroviral therapy (LA-ART) among older Americans remains limited, according to a study publishedlate last week in JAMA Network Open.Researchers found that just 3% of Medicare beneficiaries with HIV were using the injectable treatment in 2023, two years after the Food and Drug Administration approved the sustained viral suppression regimen. The findings also revealed geographic and racial disparities in who received the therapy, mirroring longstanding disparities in access to HIV care.
Use increased over time, but remained low
LA-ART, which combines the drugs cabotegravir and rilpivirine, is administered by injection every four to eight weeks and offers an alternative to taking daily oral antiretroviral medications.
For the study, researchers led by a team at Harvard T.H. Chan School of Public Health analyzed claims data from all Medicare Parts B and D beneficiaries with HIV from 2021 to 2023. They identified nearly 173,000 people with HIV enrolled in Medicare in 2023 and compared those receiving injectable therapy with those taking oral antiretroviral medications.
Use of the injectable regimen increased over time, rising from 638 patients (0.4%) in 2021 to 5,162 patients (3.0%) in 2023. But adoption of long-acting antiretrovirals remained low overall, with 97% of beneficiaries still using oral medications in 2023.
Older adults, rural residents less likely to use LA-ART
Several groups were significantly less likely to use LA-ART.
Compared with people younger than 55 years, adults ages 55 to 64 had a 40% lower [MOU1] [MV2] likelihood of receiving injectable therapy, while those age 65 and older were 60% less likely. American Indian or Alaska Native beneficiaries were almost 50% less likely than White beneficiaries to receive the treatment.
The findings suggest geography may also play a role. People living in rural areas were 27% less likely to receive LA-ART than those in urban areas, and uptake was lower in the South than in other regions of the country.
The findings highlight the need for targeted efforts to reduce cost barriers and improve access to long-acting antiretroviral treatments.
Patients with several chronic conditions, including dementia, chronic kidney disease, heart failure, and stroke, were also less likely to receive LA-ART. The researchers hypothesize that clinicians may be concerned about drug interactions for people with multiple chronic conditions so are less likely to prescribe LA-ART.
In contrast, beneficiaries with mental illness were more likely to receive LA-ART, a finding the researchers call encouraging given adherence challenges in this population.
Beneficiaries who qualified for subsidized drug coverage and those who received financial protections through out-of-pocket maximum caps and reduced cost-sharing were more likely to receive LA-ART, suggesting affordability and type of insurance may influence access.
The findings highlight the need for targeted efforts to reduce cost barriers and improve access to LA-ART among older adults, rural residents, and other underserved populations.