{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T19:16:53Z","timestamp":1774379813287,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,1,11]],"date-time":"2019-01-11T00:00:00Z","timestamp":1547164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>As more <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive individuals receive antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>), payers are seeking options for covering these increased and sustained drug costs. Strategic use of available generic antiretroviral (<jats:styled-content style=\"fixed-case\">ARV<\/jats:styled-content>) formulations may be feasible. De\u2010simplifying a single\u2010tablet co\u2010formulation (<jats:styled-content style=\"fixed-case\">STF<\/jats:styled-content>) into two or more tablets using both brand and generic drugs has been proposed. We determine if voluntary de\u2010simplification of one <jats:styled-content style=\"fixed-case\">STF<\/jats:styled-content> could be utilized as a cost\u2010saving strategy. We report on the challenges, uptake, outcomes and cost savings of this initiative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients stable on the most commonly used STF (Triumeq<jats:sup>\u00ae<\/jats:sup>) were offered the option of remaining on Triumeq<jats:sup>\u00ae<\/jats:sup> or switching to generic abacavir\/lamivudine and Tivicay<jats:sup>\u00ae<\/jats:sup> between 1 January 2015 and 1 January 2018; those starting ART consisting of abacavir\/lamivudine\/doulutegravir in the same period were offered the option of starting Triumeq<jats:sup>\u00ae<\/jats:sup> or generic abacavir\/laminvudine and Tivicay<jats:sup>\u00ae<\/jats:sup>. No incentives were provided. We examined the acceptance\/decline rates, patient satisfaction, health care outcomes and annual cost savings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 626 patients receiving Triumeq<jats:sup>\u00ae<\/jats:sup>, 321 were approached; 177 (55.1%) agreed to de\u2010simplify. Of patients initiating <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>, 62.7% chose the generic co\u2010formulation. Patients switching to or starting on the generic co\u2010formulation were more likely to be male, &gt;\u00a045\u00a0years old, Caucasian, men who have sex with men (<jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>) and more <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010experienced, and to have more comorbidities (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). Preference for <jats:styled-content style=\"fixed-case\">STF<\/jats:styled-content> was cited for declining de\u2010simplification. No concern about generic <jats:styled-content style=\"fixed-case\">ARV<\/jats:styled-content>s was expressed. The rate of viral load &gt;\u00a0500 HIV\u20101 RNA copies\/mL after baseline was 2.7% in switched patients compared with 7.0% in those declining to switch. No <jats:italic>de novo<\/jats:italic> resistance occurred. A saving of Cdn$1\u00a0319\u00a0686 was achieved in the first year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Reliance on altruism, while respecting patient autonomy, achieved de\u2010simplification in &gt;\u00a050% of patients approached, and generated immediate cost savings with no increased risk of adverse events, viral breakthrough or resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12701","type":"journal-article","created":{"date-parts":[[2019,1,11]],"date-time":"2019-01-11T10:31:42Z","timestamp":1547202702000},"page":"214-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["De\u2010simplifying single\u2010tablet antiretroviral treatments: uptake, risks and cost 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