Switching from branded Atripla to regimens that include at least one generic drug treatment is a big cost saver without compromising efficacy, according to research from Brighton presented to the recent conference of the British HIV Association (BHIVA) in Liverpool.
"The study involved 86 people who switched from one-pill Atripla to multi-pill combinations that included at least one generic. The annual cost saving associated with the treatment switch was over $200,000. That saving came from switching to a combination of tenofovir, generic efavirenz and generic lamivudine. All the study participants who switched maintained an undetectable viral load and only one person discontinued their new regimen because of pill burden.
Atripla combines efavirenz, emtricitabine and tenofovir in a single pill taken once daily. Its potency, convenience and relative safety meant that it was the preferred drug for first-line HIV therapy. Although it has now been supplanted by alternative regimens, it continues to be taken by a large number of people.
The study notes that, "switching to generics was not without its challenges, including supply of medication and patients receiving different brands. Greater than predicted use of generics led to delays in supply of stock. As a result, patients received different brands of medication when prescriptions were refilled. This meant that patients were receiving pills of differing appearance, increasing the potential for confusion about which pills had been taken."
Despite these concerns, "the investigators conclude that a regimen consisting of generic efavirenz and lamivudine with tenofovir is a viable cost-saving and well-tolerated switch option. Increased pill burden does not appear to be an issue for patients."