Potential healthcare resource use and associated costs of every 2 month injectable cabotegravir plus rilpivirine long-acting regimen implementation in the Spanish National Healthcare System compared to daily oral HIV treatments.

INTRODUCTION: HIV treatment currently consists of daily oral antiretroviral therapy (ART). Cabotegravir + rilpivirine long-acting (CAB + RPV LA) is the first ART available in Spain administered every 2 months through intramuscular injection by a healthcare professional (HCP). The objective of this analysis was to assess potential healthcare resource use (HRU) and cost impact of implementing CAB + RPV LA vs. daily oral ART at National Health System (NHS) hospitals. METHODS: Online quantitative interviews and cost analysis were performed. Infectious disease specialists (IDS), hospital pharmacists (HP) and nurses were asked about their perception of potential differences in HRU between CAB + RPV LA vs. daily oral ART, among other concepts of interest. Spanish official tariffs were applied as unit costs to the HRU estimates (€2022). RESULTS: 120 responders (n = 40 IDS, n = 40 HP, n = 40 nurses) estimated an average number of annual visits per patient by speciality (IDS, HP, and nurse, respectively) of 3.3 vs. 3.7; 4.4 vs. 6.2; 6.1 vs. 3.9, for CAB + RPV LA vs. daily oral ART, and 3.0 vs. 3.2; 4.8 vs. 5.8; 6.9 vs. 4.9, respectively when adjusting by corresponding specialist responses. Estimation by the total sample led to an annual total cost per patient of €2,076 vs. €2,473, being €2,032 vs. €2,237 after adjusting by corresponding HCP, for CAB + RPV LA vs. daily oral ART. CONCLUSIONS: These results suggest that the implementation of CAB + RPV LA in NHS hospitals would not incur in increased HRU-related costs compared to current daily oral ARTs, being potentially neutral or even cost-saving.

Temporal logics for phylogenetic analysis via model checking.

The need for general-purpose algorithms for studying biological properties in phylogenetics motivates research into formal verification frameworks. Researchers can focus their efforts exclusively on evolution trees and property specifications. To this end, model checking, a mature automated verification technique originating in computer science, is applied to phylogenetic analysis. Our approach is based on three cornerstones: a logical modeling of the evolution with transition systems; the specification of both phylogenetic properties and trees using flexible temporal logic formulas; and the verification of the latter by means of automated computer tools. The most conspicuous result is the inception of a formal framework which allows for a symbolic manipulation of biological data (based on the codification of the taxa). Additionally, different logical models of evolution can be considered, complex properties can be specified in terms of the logical composition of others, and the refinement of unfulfilled properties as well as the discovery of new properties can be undertaken by exploiting the verification results. Some experimental results using a symbolic model verifier support the feasibility of the approach.