New affordable HIV treatment

New affordable HIV treatment Estelle Greeff
Innovation in HIV treatment pricing means that more patients will not default on treatment and help boost efforts to decrease the disease in the country.

A ground-breaking pricing agreement has been reached that will fast- track the availability of the first affordable, generic, single-pill HIV treatment regimen containing Dolutegravir.

Dolutegravir is a medication used for the treatment of HIV infection.

Minister of Health Aaron Motsoaledi, together with a number of international organisations and agencies, reached the pricing agreement recently.

The new fixed-dose combination will be available to low- and middle-income countries at a reduced price of US$75 (just over R1 000) per person, per year.

Accelerating treatment

The agreement is expected to fast-track treatment roll-out as part of global efforts to reach all 36.7 million people living with HIV with high-quality antiretroviral therapy.

The announcement will likely have a significant impact on the HIV treatment programme in South Africa’s public health sector.

The HIV programme has grown from 923 000 patients on treatment in 2009 to 3.9 million patients on treatment by the end of August 2017.

In September 2016, the Minister announced the roll-out of the test and treat initiative with the aim to have six million HIV-positive patients on treatment by 2022.

Benefits for patients

South Africa will introduce the new fixed-dose combination of three drugs, Tenofovir, Lamivudine and Dolutegravir (TLD) in April 2018. It is projected this new regimen at the price announced will save South Africa more than R11 billion over the next six years.

Apart from the financial savings, which will decrease pressure on the national fiscus, its introduction will also have significant benefits for patients.

Dolutegravir is a highly effective antiretroviral, which is well tolerated by patients and has fewer side effects.

Patients are, therefore, more likely to be adherent and more likely to be virally suppressed – which means that they are not likely to transmit the virus to others.

Massive savings

“I am excited about this innovative agreement which will allow the government of South Africa to accelerate the introduction of the Dolutegravir-based fixed-dose combination, which will greatly benefit our patients due to its superior therapeutic qualities,” said Minister Motsoaledi.

“The considerable price reductions could yield savings of up to R11.7 billion over the next six years for us, which means that we can initiate additional patients on treatment with the same amount of resources. Ramping up treatment with good viral suppression will enable us to reach HIV epidemic control more quickly. We are aiming at launching the new tender in April 2018,” Minister Motsoaledi said.

The South African Government together with the Government of Kenya, in partnership with the Clinton Health Access Initiative, the Joint United Nations Programme on HIV/AIDS, the Bill & Melinda Gates Foundation, UNITAID, the United Kingdom’s Department for International Development, the United States President’s Emergency Plan for AIDSRelief, the U.S. Agency for International Development, and the Global Fund to Fight AIDS, Tuberculosis and Malaria, worked on the pricing agreement.

South Africa’s commitment to make TLD available to patients was key to securing the pricing agreement.