Generic HIV drugs ‘cheaper but less effective’
Any rise inside the use of cheaper, non-branded HIV drugs could see more patients with treatment failure, doctors warn.
Soon-to-be available generic medicines could save the usa health care system nearly $1bn a year, they are saying inside the journal Annals of Internal Medicine.
But trial data suggests generic drugs possibly slightly less effective.
And they require users to take three daily pills rather then one, increasing the chance some patients may miss doses.
The doctors calculate reduced treatment efficacy could lead to 4.4 months of life lost per patient lifetime.
At an identical time the lifetime savings could be $42,500 (£26,500) per patient, say the Massachusetts General Hospital investigators.
The currently recommended treatment for newly diagnosed patients is a single pill (Atripla) taken daily that mixes three brand-name antiretrovirals – tenofovir (Viread), emtricitabine (Emtriva) and efavirenz (Sustiva).
A generic kind of a drug that has an analogous mechanism of action to emtricitabine became available in January 2012, and a generic version of efavirenz is anticipated within the relatively near future.
Patients could soon take these two much cheaper generic drugs alongside the logo drug tenofovir.
Lead researcher Dr Rochelle Walensky said: “It is a trade-off that many folks will find emotionally difficult, and maybe even ethically impossible, to recommend.”
For patients who took their medications well and adhered to the medical regimen, the generic option can be a piece more complex but can be as effective because the standard regimen, she said.
But people who missed a dose faced treatment failure.
She said this trade-off will be more acceptable if the savings were redirected to other aspects of HIV medicine.
The researchers calculate that for each 15 patients switched to the generic-based regimen, one that is likewise infected with hepatitis C can be treated and potentially cured of that infection.
Jason Warriner, of the Terrence Higgins Trust, a UK HIV charity, said: “We welcome this research, which couldn’t be more timely.
“There are around 7,000 people diagnosed annually within the UK, meaning the price of anti-HIV drugs is rising year on year.
“With the NHS under unprecedented financial pressure, the spread of the epidemic is a challenge not only for public health but for the general public purse.
“Introducing generic medications will be a technique for the health service to attenuate expenditure, but this must never be on the expense of patient health.
“Anything that compromises the effectiveness of anti-HIV drugs, or makes people less prone to keep on with treatments, will be a false economy.
“Currently, ensuring those with HIV are diagnosed and on treatment is a cornerstone of HIV prevention efforts.
“Effective medications not just keep those living with the virus fit and well, additionally they help to maintain down new infections.”