January 16, 2013

Generic HIV Meds Could Save U.S. $1B a Year, But Risk Lowering Adherence

As first-line HIV medications begin to lose their patents, the U.S. health care system stands to save $1 billion a year, but a switch to generics may also raise the likelihood of treatment failure, MedPage Today reports. A study conducted by Massachusetts General Hospital and Weill Cornell Medical College and published in the January 15 Annals of Internal Medicine examines both the financial and health impacts of the release of generic antiretrovirals (ARVs).

Currently, the recommended therapy for treatment-naive people with HIV is the single-pill, once-a-day triple combination therapy Atripla, which is comprised of three brand-name ARVs: Viread (tenofovir), Emtriva (emtricitabine) and Sustiva (efavirenz). In January 2012, a generic form of the ARV lamivudine, which operates similarly to emtricitabine, was released. A generic of efavirenz is expected to hit the market soon.

The study indicates that adding the two generics to Viread to assemble a combination therapy comparable to Atripla would yield a lifetime savings of $42,500 for every eligible patient. Government sources, which pay for the lion’s share of HIV care in the United States, would benefit the most. However, because of the increased pill burden—there is no imminent promise of a once-a-day generic combo pill—people with HIV would likely be less adherent to the drug cocktail and run a greater risk of developing drug resistance. Furthermore, lab studies have suggested that lamivudine may be somewhat less effective than emtricitabine, as well as more likely to lead to the development of drug resistance.

To read the MedPage Today article, click here.

To read the Mass General Hospital and Weill Cornell Medical College release, click here.

To read the abstract of the study, click here.

Editor's Note: This article has been updated.

Search: HIV, antiretrovirals, ARV, medications, patent, savings, generic, MedPage Today, Massachusetts General Hospital, Weill Cornell Medical College, Atripla, Viread, tenofovir, Emtriva, emtricitabine, Sustiva, efavirenz, lamivudine

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Previous Comments:

Shedonehimwrong, Orlando, 2013-01-23 10:34:54
After almost 30 years of HIV your would think that congress and drug makers would insist on reliable low cost generic drugs for people with HIV...a lifesaving drug should cost 20K a year and upward. It always the same old excuses...doubt it will ever change...time for generics is NOW

David, Wellington, New Zealand, 2013-01-23 01:44:20
Speculation about the impact on adherence of 3 pills vs 1 is not helpful - we need the savings from generics. Empirical research is needed. My own experience is that it makes no difference. I went from Atripla when I was in the UK to the 3 pill combo when I moved to NZ (NZ public health system funds the individual pills but does not fund Atripla). My adherence has not changed one jot. Developing the habit of taking meds is what counts not how many pills.

Tim, , 2013-01-23 00:54:39
I know someone who had to go without meds because he was jobless. His cd4 count dropped below 50 before my state pulled it's head out of it's butt and started funding HIV. Can we stop talking about how good we have it "compared to the bad old days"? Death by AIDS is death by AIDS,regardless of the decade. The constant deference and hierarchy within HIV politics is ridiculous.

Michael, NYC, 2013-01-22 16:07:31
Phil, I think the resulting therapy could be two or three pills instead of the one pill... Very little trouble considering what guys in the 80s/early 90s had to do! When I hear guys now complain about one or two or three pills, I wanna slap 'em... We have it SO easy now compared to then.

Phil, Panama City, 2013-01-22 14:13:58
I do not understand how saving on HIV Meds would lower adherance to taking the medications. I really need cheaper meds.