Thailand offers triple HIV therapy at $27 per month

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Thailand’s Government Pharmaceutical Organisation is to begin production of a three drug combination in one tablet that will cost only $27 per month, a 75% reduction in the cost of treatment with d4T, 3TC and nevirapine compared to current prices.

The product, called GPO-Vir, will become available in April. The Government Pharmaceutical Organisation joins the Indian companies Cipla, Aurobindo and Ranbaxy, which already offer a three drug in one tablet formulation of d4T, 3TCand nevirapine at a similar price.

Speaking last month at the Ninth Annual Retroviruses Conference in Seattle, Dr Praphan Phanuphak of the Thai Red Cross AIDS Research Centre said “This will make triple therapy affordable for many Thais”. However, he pointed out that second-line treatment options would be considerably more expensive.

Glossary

generic

In relation to medicines, a drug manufactured and sold without a brand name, in situations where the original manufacturer’s patent has expired or is not enforced. Generic drugs contain the same active ingredients as branded drugs, and have comparable strength, safety, efficacy and quality.

nucleoside

A precursor to a building block of DNA or RNA. Nucleosides must be chemically changed into nucleotides before they can be used to make DNA or RNA. 

second-line treatment

The second preferred therapy for a particular condition, used after first-line treatment fails or if a person cannot tolerate first-line drugs.

drug resistance

A drug-resistant HIV strain is one which is less susceptible to the effects of one or more anti-HIV drugs because of an accumulation of HIV mutations in its genotype. Resistance can be the result of a poor adherence to treatment or of transmission of an already resistant virus.

formulation

The physical form in which a drug is manufactured or administered. Examples of formulations include tablets, capsules, powders, and oral and injectable solutions. A drug may be available in multiple formulations.

“AZT/DDI and a protease inhibitor will be five times more expensive, making it difficult for people to switch therapy”, he said.

He also highlighted the limited choices facing many Thais who have only been able to afford dual therapy with nucleoside analogues until now. He said that many patients will be willing to pay $70 for a resistance test in order to find out whether they can switch to the new low-cost triple combination. In a cohort of 145 Thai patients who had been receiving AZT/ddI for up to six years, he reported that 42 had evidence of drug resistance, with one-third having more than four nucleoside analogue mutations.

He also reported that the Thai Government Pharmaceutical Organisation has requested bioequivalence data from Indian manufacturers for generic antiretroviral agents, and is carrying out its own bioequivalence tests to ensure that generic products have the same pharmacokinetics as branded antiretrovirals.