LAUSR

The present study sought describe the use of generic drugs and single-tablet regimen (STR) de-simplification for the treatment of 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 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 AZT/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 to20% of the hospitals de-simplified EFV/TDF/FTC, DTG/ABC/3TC and RPV/TDF/FTC (to generic EFV+TDF/FTC, DTG+generic ABC/3TC and RPV+generic TDF/FTC respectively) while 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 (IQR: 369-1119) and 234 (IQR: 142-264) days, respectively; this time was 155 (IQR: 28 - 287) days for de-simplification of DTG/ABC/3TC. In conclusion, in spite of the widespread use of generic ARVs, STRs de-simplification was only undertaken in less than 20% of the hospitals. There was wide variability in the timing of the introduction of each generic ARVs after they were available in the market.