title: Patients' Willingness to Take Multiple-Tablet Antiretroviral Therapy Regimens for Treatment of HIV.
abstract: BACKGROUND
  The costs of combination antiretroviral therapy (cART) for HIV, consisting of separate, particularly generic, components (multiple-tablet regimens, MTR) are generally much lower than those of single-tablet regimens (STR) comprising the same active ingredients.
  
  
  OBJECTIVE
  To assess whether patients would be willing to take MTR, once-daily, instead of STR, with the goal of reducing general healthcare costs. In addition, we aimed to examine whether willingness was associated with particular patient characteristics.
  
  
  METHODS
  Data from the ATHENA cohort database in The Netherlands of adult HIV-1-infected patients in care and taking cART ≥6 months were used to select 1000 potential participants for an online patient survey on patient preferences and satisfaction. Participants were asked whether they would be willing to take three pills with the equivalent active ingredients simultaneously instead of STR to reduce costs. Multivariate logistic regression was used to examine associations between patient characteristics and willingness to take MTR instead of STR.
  
  
  RESULTS
  Forty-seven percent (n= 152) of the 322 respondents answered 'yes' and 26 % (n= 83) answered 'maybe' when asked whether they would be willing to take three pills with the equivalent active ingredients simultaneously to reduce costs. Non-Dutch patients were significantly more likely to answer 'no' (OR: 2.49; 95 % CI: 1.17-5.30) or 'maybe' (OR: 2.63; 95 % CI: 1.24-5.60). Answering 'no' was less common among patients who had been taking cART ≥15 years (OR: 0.23; 95 % CI: 0.09-0.58). Commonly reported concerns included the dosing frequency, efficacy and tolerability of MTR.
  
  
  CONCLUSIONS
  HIV-infected patients do not necessarily oppose the decision to prescribe MTR instead of STR to reduce healthcare costs. However, the potential trade-off in terms of convenience should be carefully weighed against the projected savings.
authors.affiliation: Division of Infectious Diseases, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands ; Stichting HIV Monitoring, Amsterdam, The Netherlands.
authors.forename: Esther A N
authors.initials: EA
authors.lastname: Engelhard
authors.affiliation: Stichting HIV Monitoring, Amsterdam, The Netherlands.
authors.forename: Colette
authors.initials: C
authors.lastname: Smit
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Sigrid C J M
authors.initials: SC
authors.lastname: Vervoort
authors.affiliation: HIV Vereniging Nederland (Dutch HIV Association), Amsterdam, The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Smit
authors.affiliation: Department of Medical Psychology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Pythia T
authors.initials: PT
authors.lastname: Nieuwkerk
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Frank P
authors.initials: FP
authors.lastname: Kroon
authors.affiliation: Division of Infectious Diseases, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands ; Stichting HIV Monitoring, Amsterdam, The Netherlands ; Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands ; Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
authors.affiliation: Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Kees
authors.initials: K
authors.lastname: Brinkman
authors.affiliation: Division of Infectious Diseases, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Geerlings