Posted on :Tuesday , 31st October 2017
The first low-price, single-pill antiretroviral treatment is likely to be made available in 90 LMIC (low and middle income) countries thanks to a breakthrough costing agreement for HIV drugs. The regime which contains DTG (dolutegravir) could become extensively available in LMIC countries for about a tenth of the current price – around US $75 per person per year.
The deal came about due to collaborative efforts between national governments, UN agencies, NGOs, and pharmaceutical manufacturers. As more nations will be able to initiate treatment on more people without increasing the budget, treatment coverage is expected to grow. With the help of the agreement, it is possible to sublicense DTG in 92 countries at a price ceiling that pertains to low and middle-income countries.
Kenya started the use of generic DTG this year, while South Africa is set to make the treatment ubiquitous in April 2018, with savings gauged at US $900 million over the coming six years.
‘This agreement will improve the quality of life for millions of people living with HIV. To achieve the 90-90-90 treatment targets, newer, affordable and effective treatment options must be made available—from Baltimore to Bamako—without any delay,’ said the UNAIDS Executive Director Michel Sidibé.
DTG offers faster viral load suppression, fewer side effects and better defense against drug resistance, but until now has been too expensive for LMICs. It is widely used in high-income countries and is recommended by the World Health Organization as an alternative first-line HIV regimen.
While being a drug that offers fewer side effects, improved defense and quicker viral load suppression, DTG has been an expensive drug until now. It is recommended by WHO (World Health Organisation) as an alternate first-line HIV regimen and is also widely used by developed high-income countries.
The effectiveness of DTG will probably manifest into more people staying within this HIV Treatment. Hence, its extensive use will supposedly decrease the need for more costly second- and third-line regimens, which people are moved onto should their first treatment regimen be unsuccessful.
After the agreement announcement, issues were raised that plans for a 17% budget cut of the Presidential Emergency Plan for AIDS Relief (PEPFAR), which amounts to the US $3.8 billion from the US $4.6 billion could threaten the rollout of the generic drug in some countries.
Dr. Larkin Callaghan, Director of Strategic Communications and Partnerships at the Aids Research Institute at the University of California, San Francisco while talking to The Independent, said the DTG pricing deal “should underscore the need for PEPFAR to remain fully funded.”
Furthermore, the Medicines Control Council stated that only two pharmaceutical companies have applied to register the drug as of now. This indicates limited competition when companies tender for drug supply next April, as there is scarce time for competitors to have their drugs approved by then.
Lotti Rutter, Treatment Action Campaign spokeswoman, said that more manufacturers should have entered the market so as to reach the lowest possible price for the new regimen.