JOHANNEBSURG, 26th SEPTEMBER 2017 – The Treatment Action Campaign (TAC) welcomes the announcement that a newer and better first line antiretroviral regimen will be made available in the public sector in South Africa and many other countries at a lower price than the current first line regimen. While many countries will benefit directly from the lower price, steps should be taken to ensure that currently excluded countries like Thailand and Malaysia can also benefit from the deal.
The new regimen will replace efavirenz with dolutegravir. We are excited about dolutegravir since it has hardly any side effects, it is highly effective at suppressing HIV, and it provides remarkably good protection against the development of drug-resistance. It also helps that the required dosage for dolutegravir is very low, allowing for much smaller pills.
The improved tolerability of the new regimen should make it easier for people to adhere to treatment. It should also reduce the need for people to switch treatments since it is anticipated that extremely few people will develop resistance to dolutegravir. We urge the South African Health Products Regulatory Authority (SAHPRA) to fast-track the registration of all generic dolutegravir products so that there can be maximum competition by the time the next ARV tender is advertised.
It is impressive that the entire three-drug regimen will be available for a maximum of US$ 75 per year. Currently, a month’s supply of the originator version of dolutegravir alone costs almost that much in South Africa – a strong indication that people are currently being over charged.
Capping the price at US$ 75 per person per year – US$ 25 lower than the current first line regime – will encourage governments to quickly make the shift to this improved regimen. We encourage multiple generic manufacturers to enter the market to ensure this regimen reaches its lowest price. Unfortunately, many middle-income countries remain excluded from this deal. We urge the governments of these countries to issue compulsory licenses to obtain access to more affordable versions of this HIV treatment more quickly.
Dolutegravir is part of a new class of antiretroviral medicine and the first integrase inhibitor to become widely available. While this regimen is a significant step forward, we think it is possible that there will soon be a strong case for also replacing tenofovir disoproxil fumarate (TDF) with tenofovir alafenamide (TAF). TAF can be taken at a lower dosage than TDF and also appears to have less side effects. We are eagerly awaiting the results of the ongoing ADVANCE trial which will provide critical evidence on the use of dolutegravir and TAF in the same regimen.
For more information or to arrange interviews please contact:
Lotti Rutter | 072 225 7695 | firstname.lastname@example.org
Read TAC and HIV i-base’s guide to the ADVANCE study here: tac.org.za/wp-content/uploads/2017/07/The_ADVANCE_trial.pdf