Review of high cost drug regimens

Clinicians and patients should consider reviewing historical high cost regimens including first line STRs and complex salvage HIV regimens in light of alternative available medicines and new data (in particular switch data for newly available STRs), to assess if simplified combinations can be used, whilst maintaining optimal viral suppression, adherence and clinical outcomes. Some NHS Boards have supported this by highlighting complex regimens to clinicians responsible for ongoing clinical care or identifying patients on high cost combinations due to changes in ART pricing. Again it is essential that patient views are considered for any discussions regarding potential switching of ART medicines and MDT discussion utilised for complex switches.