Case-03: Marketing

Introducing Past Case Studies using Data from MDV Database.

Case Study (Marketing)

Switch Rates, Time-to-switch, and Switch Patterns of Antiretroviral Therapy in People Living with Human Immunodeficiency Virus in Japan, using a Hospital-claim Database

Ruzicka DJ, Kuroishi N, Oshima N, et al. Switch rates, time-to-switch, and switch patterns of antiretroviral therapy in people living with human immunodeficiency virus in Japan, in a hospital-claim database. BMC Infect Dis. 2019;19(1):505. Published 2019 Jun 10. doi:10.1186/s12879-019-4129-6


  • Antiretroviral therapy (ART)
    contributes to extend HIV patient’s life expectancy
  • Combination of the following medications have been
    the recommended regimen in Japanese guidelines:
  • Backbone therapy: 2 nucleoside reverse transcriptase inhibitors
  • Add on of an anchor drug among:
  • Integrase strand transfer inhibitors (INSTIs)
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • Protease inhibitors (PIs)
  • Entry inhibitors (Els)

Objectives of Study

To understand the switch rates and time-to-switch of ART regimens in patients with HIV between 2008 to 2016 in Japan

Study Design and Criteria

Study Design: Retrospective Observational Database Study.

Target Period: April 2008 – December 2016

Definition of Regimen Switch

Regimen switch is referring to only when adopting anchor drug classes.

Change in anchor drug classes within 28 days of a different anchor drug is considered a change in regimen.

Patient Disposition

Distributions of anchor drug class and backbone in the ART regimens by year

Switching Patterns and Timing

Switching patterns of anchor drug class in ART regimens by switching timing from 2011 to 2016


Time-to-switch of ART regimens according to anchor drug class from 2011 to 2016


  • An ART regimen including INSTI maintained a low switch rate for long duration.
  • The major switch was seen mainly from NNRTI or PI to INSTI for secondary treatment suggesting INSTI is rather a tentative treatment approach for HIV patients

Service used for the Case Study:

Abbreviation in Article

AEAdverse event
ARTAntiretroviral therapy
CIConfidence interval
EIEntry inhibitor
HIVHuman immunodeficiency virus
HRHazard ratio
ICD-10The International Statistical Classification of Diseases and Related Health Problems 10th Revision
INSTIIntegrase strand transfer inhibitor
NNRTINon-nucleoside reverse transcriptase inhibitor
NRTINucleoside reverse transcriptase inhibitor
PIProtease inhibitor
PLWHPeople living with human immunodeficiency virus
TAFTenofovir alafenamide fumarate
TDFTenofovir disoproxil fumarate

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About Japanese Healthcare System

What you need to know about the healthcare system in Japan before using the data.


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