Outside of convenience, the only major benefit of multi-antiretroviral (ARV) combination tablets could be to pharmaceutical companies’ bottom line. Taking individual pills—which can be much cheaper if generic components are available—apparently combats HIV just as well. This is according to a review of nine trials, including over 2,500 HIV-positive participants, that compared single-tablet HIV regimens with their individual-tablet equivalents. All of the single-tablet regimen comparison trials included virally suppressed participants switching from stable ARV treatment to a new regimen.

The rate of virologic failure, defined as having a viral load above 400 in two consecutive tests, was comparable between those taking combination tablets and those taking individual pills. There was no significant difference in the rate of drug resistance or of people switching treatment because of side effects.

The study’s head, Andrew Hill, PhD, a senior research fellow at Liverpool University, notes that the crop of avail--able generic HIV medications will expand in the coming years. “There is the potential for huge savings by switching from patented single-tablet regimens to generic alternatives,” he says.