{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:38:06Z","timestamp":1789738686546,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T00:00:00Z","timestamp":1556496000000},"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":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Reliable and timely HIV care cost estimates are important for policy option appraisals of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment and prevention strategies. As <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> clinical management and outcomes have changed, we aimed to update profiles of antiretroviral (ARV) usage pattern, patent\/market exclusivity details and management costs in adults (\u2265\u00a018\u00a0years old) accessing <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> specialist care in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data reported quarterly to the <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content> Reporting System in England was used to identify <jats:styled-content style=\"fixed-case\">ARV<\/jats:styled-content> usage pattern, and were combined with British National Formulary (<jats:styled-content style=\"fixed-case\">BNF<\/jats:styled-content>) prices, non\u2010<jats:styled-content style=\"fixed-case\">ARV<\/jats:styled-content> care costs and patent\/market exclusivity information to generate average survival\u2010adjusted lifetime care costs. The cumulative budget impact from 2018 to the year in which all current <jats:styled-content style=\"fixed-case\">ARV<\/jats:styled-content>s were expected to lose market exclusivity was calculated for a hypothetical 85\u00a0000 (\u00b1 5000) person cohort, which provided an illustration of potential financial savings afforded by bioequivalent generic switches. Price scenarios explored <jats:styled-content style=\"fixed-case\">BNF<\/jats:styled-content>70 (September 2015) prices and generics at 10\/20\/30\/50% of proprietary prices. The analyses took National Health Service (<jats:styled-content style=\"fixed-case\">NHS<\/jats:styled-content>) England's perspective (as the payer), and results are presented in 2016\/2017 British pounds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>By 2033, most currently available <jats:styled-content style=\"fixed-case\">ARV<\/jats:styled-content>s would lose market exclusivity; that is, generics could be available. Average per person lifetime <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> cost was ~\u00a3200\u00a0000 (3.5% annual discount) or ~\u00a3400\u00a0000 (undiscounted), reducing to ~\u00a370\u00a0000 (3.5% annual discount; ~\u00a3120\u00a0000 undiscounted) with the use of generics (assuming that generics cost 10% of proprietary prices). The cumulative budget to cover 85\u00a0000 (\u00b1 5000) persons for 16\u00a0years (2018\u20132033) was \u00a310.5 (\u00b1 0.6) billion, reducing to \u00a33.6 (\u00b1 0.2) billion with the use of generics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HIV management costs are high but financial efficiency could be improved by optimizing generic use for treatment and prevention to mitigate the high cost of lifelong <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment. Earlier implementation of generics as they become available offers the potential to maximize the scale of the financial savings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12725","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T21:36:53Z","timestamp":1556660213000},"page":"377-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>HIV<\/scp> care cost in England: a cross\u2010sectional analysis of antiretroviral treatment and the impact of generic introduction"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5839-6747","authenticated-orcid":false,"given":"KJ","family":"Ong","sequence":"first","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AJ","family":"van Hoek","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UK"},{"name":"Centre for Infectious Diseases Rijksinstituut voor Volksgezondheid en Milieu, RIVM (Netherlands National Institute for Public Health and the Environment) Bilthoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RJ","family":"Harris","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Figueroa","sequence":"additional","affiliation":[{"name":"NHS England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Waters","sequence":"additional","affiliation":[{"name":"Central and North West London NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Chau","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2220-623X","authenticated-orcid":false,"given":"S","family":"Croxford","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Kirwan","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6490-6739","authenticated-orcid":false,"given":"A","family":"Brown","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MJ","family":"Postma","sequence":"additional","affiliation":[{"name":"Unit of Pharmacotherapy, Epidemiology &amp; Economics Department of Pharmacy University of Groningen Groningen The Netherlands"},{"name":"Department of Health Sciences University of Groningen University Medical Center Groningen Groningen The Netherlands"},{"name":"Department of Economics, Econometrics &amp; Finance Faculty of Economics &amp; Business University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ON","family":"Gill","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Delpech","sequence":"additional","affiliation":[{"name":"National Infection Service Public Health England London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,29]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Public Health England.HIV: annual data tables [Internet]. 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