Switching from single-tablet branded Atripla (efavirenz/tenofovir disoproxil fumarate/emtricitabine) to antiretroviral (ARV) regimens containing one or two generic HIV drugs yields considerable cost savings without compromising the efficacy of treatment, aidsmap reports. However, some of those who switch regimens may wind up switching again to avoid new side effects they may incur.
Pharmacists and physicians reviewed clinical notes and pharmacy data on 428 individuals who were receiving Atripla between August 2015 and March 2017 and who lacked a clinical reason to switch their ARVs. A total of 268 of them were referred to a pharmacist to discuss switching to one of two regimens: generic efavirenz (Sustiva), generic lamivudine (Epivir) and branded Viread (tenofovir disoproxil fumarate); or generic efavirenz and branded Truvada (tenofovir disoproxil fumarate/emtricitabine).
Findings were presented at the conference of the British HIV Association (BHIVA) in Liverpool.
A total of 119 people (44 percent) agreed to switch to one of these multi-tablet regimens, with 86 of them ultimately switching to efavirenz/lamivudine/Viread disoproxil fumarate and 29 to efavirenz/Truvada.
The most common reason for declining to switch regimens, cited by 41 people, was the desire to stay on a single-tablet regimen.
Of those who switched regimens, three quarters remained on their new regimen while a fifth wound up switching again as a result of central-nervous system side effects; most of those individuals went back to taking Atripla. Just one person said the extra number of tablets in the generic-containing regimen was a reason for wanting to switch ARVs again.
All those who switched to a generic-containing regimen maintained a fully suppressed viral load six and 12 months after switching to it.
The researchers estimated that the cumulative annual savings yielded from switching this group from Atripla to one of the two generic-containing regimens was £159,500, or about $200,000.
To read the aidsmap article, click here.