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Generic HIV treatment strategy could save nearly $1 billion annually but may be less effective
Date:1/14/2013

NEW YORK (Jan. 14, 2013) -- Replacing the combination of brand-name, antiretroviral drugs currently recommended for control of HIV infection with soon-to-be-available generic medications could save the U.S. health care system almost $1 billion a year but may diminish the effectiveness of HIV treatment. A study led by Massachusetts General Hospital (MGH) and Weill Cornell Medical College investigators, appearing in the January 15 Annals of Internal Medicine, examines the potential impact of such a change.

"The switch from branded to generic antiretrovirals would place us in the uncomfortable position of trading some losses of both quality and quantity of life for a large potential dollar savings," says Rochelle Walensky, MD, MPH, of the MGH Medical Practice Evaluation Center, lead author of the study. "By estimating the likely magnitude of these offsetting effects now before generic antiretrovirals actually hit the shelves we can confront our willingness as clinicians, patients and as a society to make these difficult choices."

In 2011 the cost of antiretroviral drugs in the U.S. was around $9 billion, most of which was paid for by government sources. The currently recommended treatment for newly diagnosed patients is a single pill (Atripla) taken daily that combines three brand-name antiretrovirals: tenofovir (Viread), emtricitabine (Emtriva) and efavirenz (Sustiva). A generic form of the antiretroviral drug lamivudine, which has a similar mechanism of action to emtricitabine, became available in January 2012, and a generic version of efavirenz is expected in the relatively near future.

Replacing two of the three branded drugs with generics could significantly reduce costs, the authors note, but such a strategy would also have disadvantages. A more complicated treatment regimen, requiring three daily pills instead of one, increases the risk that some patients will miss doses, leading to the loss of antiretroviral eff
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Contact: Lauren Woods
Law2014@med.cornell.edu
646-317-7401
Weill Cornell Medical College
Source:Eurekalert

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