The present study sought to describe the use of generic drugs and single-tablet regimen (STR) de-simplification for the treatment of human immunodeficiency virus (HIV) infection among 41 hospitals from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). In June 2018, we collected information on when generic antiretroviral drugs (ARVs) were introduced in the different hospitals, how the decisions to use them were made, and how the information was provided to the patients. Most of the nine available generic ARVs in Spain by June 2018 had been introduced in at least 85% of the participating hospitals, except for zidovudine (AZT)/lamivudine (3TC) and AZT. The time difference between the effective marketing date of each generic ARV and its first dispensing date in the hospitals was much shorter for the more recently approved generic ARV since the year 2017. However, only up to 20% of the hospitals de-simplified efavirenz (EFV)/tenofovir disoproxil (TDF)/emtricitabine (FTC), dolutegravir (DTG)/abacavir (ABC)/3TC, and rilpivirine (RPV)/TDF/FTC (to generic EFV+TDF/FTC, DTG+generic ABC/3TC, and RPV+generic TDF/FTC, respectively), whereas the generic STR EFV/TDF/FTC was introduced in 87.8% of the centers. The median times between the date of effective marketing of generic TDF/FTC and the date of de-simplification of EFV/TDF/FTC and RPV/TDF/FTC were 723 [interquartile range (IQR): 369–1,119] and 234 (IQR: 142–264) days, respectively; this time was 155 (IQR: 28–287) days for de-simplification of DTG/ABC/3TC. In conclusion, despite the widespread use of generic ARVs, STRs de-simplification was only undertaken in <20% of the hospitals. There was wide variability in the timing of the introduction of each generic ARV after they were available in the market.

中文翻译：

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在西班牙使用通用抗逆转录病毒药物和单片方案去简化治疗 HIV 感染

本研究旨在描述西班牙 HIV/AIDS 研究网络 (CoRIS) 队列的 41 家医院使用仿制药和单片方案 (STR) 去简化治疗人类免疫缺陷病毒 (HIV) 感染的情况. 2018 年 6 月，我们收集了有关不同医院何时引入抗逆转录病毒仿制药 (ARV)、如何做出使用决定以及如何向患者提供信息的信息。除齐多夫定 (AZT)/拉米夫定 (3TC) 和 AZT 外，截至 2018 年 6 月，西班牙至少有 85% 的参与医院引入了九种可用的通用抗逆转录病毒药物中的大多数。自 2017 年以来，对于最近获批的仿制药 ARV，每种仿制药 ARV 的有效上市日期与其在医院首次配药日期之间的时间差要短得多。然而，只有高达 20% 的医院取消了依非韦伦（ EFV)/替诺福韦地索普西 (TDF)/恩曲他滨 (FTC)、多替拉韦 (DTG)/阿巴卡韦 (ABC)/3TC 和利匹韦林 (RPV)/TDF/FTC（通用 EFV+TDF/FTC、DTG+通用 ABC/3TC和 RPV+通用 TDF/FTC），而 87.8% 的中心引入了通用 STR EFV/TDF/FTC。通用 TDF/FTC 有效上市日期与 EFV/TDF/FTC 和 RPV/TDF/FTC 去简化日期之间的中位时间为 723 [四分位距 (IQR)：369–1,119] 和 234 (IQR : 分别为 142–264) 天；这次是 155 (IQR: DTG/ABC/3TC 去简化需要 28–287) 天。总之，尽管通用 ARV 广泛使用，但仅在 <20% 的医院中进行了 STR 去简化。每种仿制抗逆转录病毒药物上市后的时间差异很大。