HIV treatment

Significant reductions in price of first- and second-line HIV treatment thanks to UNITAID and Clinton deal

Michael Carter
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HIV treatment consisting of just one pill, once a day, will be available in poorer countries at a cost of $210 per patient, per year, thanks to an agreement announced by UNITAID and the Clinton HIV/AIDS Initiative.

The price of boosted protease inhibitor-based second-line HIV treatment will also fall significantly to an annual cost per patient of $590.

Deals were struck by UNITAID and the Clinton Initiative with generic manufacturers to enable these price cuts.

Glossary

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.

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.

first-line therapy

The regimen used when starting treatment for the first time.

boosting agent

Booster drugs are used to ‘boost’ the effects of protease inhibitors and some other antiretrovirals. Adding a small dose of a booster drug to an antiretroviral makes the liver break down the primary drug more slowly, which means that it stays in the body for longer times or at higher levels. Without the boosting agent, the prescribed dose of the primary drug would be ineffective.

paediatric

Of or relating to children.

Thanks to the deals, there is a 17% reduction in the price of the most affordable second-line antiretroviral combination of 3TC, tenofovir and ritonavir-boosted lopinavir for the world’s poorest countries.

Heat-stable lopinavir/ritonavir will be available at a maximum cost of $470 per patient, per year. Generic versions of atazanavir and heat-stable ritonavir are expected to yield further price decreases.

UNITAID-funded projects in 42 poorer countries will benefit from the reductions in the cost of second-line treatment. They will also be available to over 70 developing countries that are members of the Clinton HIV/AIDS Initiative’s Procurement Consortium, as well as being extended to participants in the Global Fund’s Voluntary Pooled Procurement scheme.

More tolerable and convenient first-line HIV treatment will also become more affordable, thanks to new price agreements. A single pill that combines HIV treatment consisting of 3TC, tenofovir and efavirenz in a single pill taken once a day will be available for an annual per-patient cost of $210. This price compares with a maximum cost of $89 a year for a fixed-dose combination of d4T, 3TC and nevirapine, which is taken twice daily. This represents a reduction of 30% on prices agreed by UNITAID and the Clinton Initiative in 2008, and is over a third lower than the average cost of this combination in low-income countries.

The latest agreements between UNITAID and the Clinton initiative will bring down the price of 41 adult and paediatric formulations of anti-HIV drugs. The new prices are on average 16% lower than the lowest prices in 2008. Since 2007, UNITAID and Clinton deals have helped bring about a 62% reduction in the price of first-line HIV therapy for the world’s poorest countries hardest hit by HIV. Price reductions for second-line treatment are projected to bring annual savings of $100 million.

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