HIV PILL AGREEMENT
UNAIDS deal will make state-of-the-art HIV drug affordable in SA
The deal guarantees a maximum price of $75 per person per year for three-in-one pills containing Dolutegravir, Tenofovir and Lamivudine
A state-of-the art HIV pill containing Dolutegravir, already widely used in rich countries, is set to become more quickly available at an affordable price in SA, thanks to an agreement announced by UNAIDS in New York on Thursday night.
The deal guarantees a maximum price of $75 per person per year for three-in-one pills containing Dolutegravir, Tenofovir and Lamivudine, made by pharmaceutical companies Mylan and Aurobindo under licence from Viiv Healthcare.
The development is important because it increases competition for SA’s next AIDS drug tender and is expected to help push down the cost of HIV treatment.
It is also good news for patients, as recent research has shown Dolutegravir is more effective and better tolerated than antiretrovirals such as Efavirenz and Nevirapine.
A working group established by the health department recently recommended switching patients to a once-daily fixed dose combination of Tenofovir, Lamivudine and Dolutegravir as first-line treatment, on both clinical and economic grounds.
SA has the world’s biggest HIV burden, and the largest number of people on treatment in the world: at the last count about 7.1-million people were living with HIV and just over 4-million were on treatment.
"The considerable price reductions could yield savings of up to $900m over the next six years, which means we can initiate additional patients on treatment with the same amount of resources," said Health Minister Aaron Motsoaledi.
The deal was brokered by the Clinton Health Access Initiative (CHAI) and the Bill and Melinda Gates Foundation in order to accelerate the availability of a new fixed-dose combination to the public sector in 90 low-and middle-income countries at reduced prices. CHAI has a long-standing relationship with the South African health department and played a pivotal role in helping it negotiate the world’s lowest HIV prices.
The South African and Kenyan governments, along with the UK’s department for international development and the US President’s Emergency Plan for AIDS Relief and the Global Fund to fight AIDS, Tuberculosis and Malaria, were also involved.
"This groundbreaking agreement will help improve the lives of millions of patients.... This drug combination is better tolerated and more effective and will lead to improved health outcomes by ensuring that fewer HIV patients develop drug resistance and that more remain on treatment," said CHAI CEO Ira Magaziner.
SA’s current AIDS drug tender comes to an end in March, but is likely to be extended to ensure companies have enough time to register Dolutegravir-containing pills with the Medicines Control Council, the health department has previously said.
GlaxoSmithKline is the sole supplier of Dolutegravir in SA and its two products, Tivicay and Trelavue, are available only in the private sector. Tivicay contains Dolutegravir alone and will cost a patient R850 a month.
UNAIDS said the new drugs were expected to become available in 2018.