OBJECTIVES: Given the availability of a growing number of HIV treatment options, this study aims to generate economic and organizational evidence that may support a rational use of resources for the treatment of both naïve and experienced HIV individuals, within the Italian National Healthcare Service (NHS), operating informed and conscious choices.

METHODS: A budget impact analysis, representing the Italian NHS healthcare expenditure evolution over three years, was developed, considering the overall Italian HIV treated population (N=101,819: 24,916 treatment-naïve and 76,903 treatment-experienced individuals). Patient’s treatment history, treatment regimen, development of adverse events, achievement of an undetectable viral load and direct healthcare total costs were the model input variables. Scenario A, representative of the current situation of consumption and penetration rate of the different therapeutic alternatives (derived from the most update guidelines), was compared with a Scenario B, assuming a greater adoption of BIC/FTC/TAF.

Data were collected from scientific evidence, Italian national and regional legislations, and healthcare professionals’ reports. Results are expressed both in economic and organizational terms.

RESULTS: From an economic perspective, any modification in the current case-mix of HIV therapy (thus hypothesizing a greater use of BIC/FTC/TAF) is related to an economic saving equal to -€26.040.271, in total health spending, for the Italian NHS. From an organizational perspective, this modification would reduce the overall hospital accesses devoted to the management of adverse events and/or complications, generating an overall saving of 245,938 hours, considering the time spent by the healthcare professionals involved in the care and treatment of individuals with HIV.

CONCLUSIONS: BIC/FTC/TAF represents an interesting possibility for the rapid initiation of ART, as well as for switches, being able to optimize the clinical pathway of a patient with HIV, from an economic and organizational perspective.