Cost-Effectiveness of Generic Antiretroviral Therapy
Authors: Gottfried Hirnschall, Cornelis de Joncheere
Journal: Annals of Internal Medicine (2013)

Letters21 May 2013Cost-Effectiveness of Generic Antiretroviral TherapyGottfried Hirnschall, MD, MPH and Cornelis de Joncheere, PharmD, MSc, MBAGottfried Hirnschall, MD, MPHFrom World Health Organization, Geneva, Switzerland.Search for more papers by this author and Cornelis de Joncheere, PharmD, MSc, MBAFrom World Health Organization, Geneva, Switzerland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-10-201305210-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Walensky and colleagues (1) provide important estimates of the potential cost savings associated with the introduction of generic-based antiretroviral therapy in the United States. Using conservative assumptions, they estimate first-year savings of up to $920 million and lifetime average savings of $42 500 per eligible patient. However, the authors caution that this introduction may require a tradeoff between drug efficacy and cost savings, because the regimens proposed in the model are not available as fixed-dose combinations, may have inferior efficacy, and could lead to poor adherence.We would like to highlight 3 points related to this analysis. First, ...References1. Walensky RP, Sax PE, Nakamura YM, Weinstein MC, Pei PP, Freedberg KA, et al. Economic savings versus health losses: the cost-effectiveness of generic antiretroviral therapy in the United States. Ann Intern Med. 2013;158:84-92. [PMID: 23318310] LinkGoogle Scholar2. World Health Organization. Pharmacological Equivalence and Clinical Interchangeability of Lamivudine and Emtricitabine: A Review of Current Literature. Technical Update on Treatment Optimization. Geneva: World Health Organization; 2012. Google Scholar3. Médecins Sans Frontières. Untangling the web of antiretroviral price reductions. July 2012. Accessed at http://utw.msfaccess.org/ on 16 April 2013. Google Scholar4. Ford N, ‘t Hoen E. Generic medicines are not substandard medicines [Letter]. Lancet. 2002;359:1351. [PMID: 11965315] CrossrefMedlineGoogle Scholar5. Stringer JS, Mwango AJ, Giganti MJ, Mulenga L, Levy JW, Stringer EM, et al. Effectiveness of generic and proprietary first-line anti-retroviral regimens in a primary health care setting in Lusaka, Zambia: a cohort study. Int J Epidemiol. 2012;41:448-59. [PMID: 22493326] CrossrefMedlineGoogle Scholar6. Study questions generic HIV drug use. BBC News. 16 January 2013. Accessed at www.bbc.co.uk/news/health-21012160 on 16 April 2013. Google Scholar Author, Article, and Disclosure InformationAffiliations: From World Health Organization, Geneva, Switzerland.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEconomic Savings Versus Health Losses: The Cost-Effectiveness of Generic Antiretroviral Therapy in the United States Rochelle P. Walensky , Paul E. Sax , Yoriko M. Nakamura , Milton C. Weinstein , Pamela P. Pei , Kenneth A. Freedberg , A. David Paltiel , and Bruce R. Schackman Cost-Effectiveness of Generic Antiretroviral Therapy Rochelle P. Walensky , A. David Paltiel , and Bruce R. Schackman Metrics Cited ByFrench 2013 guidelines for antiretroviral therapy of HIV-1 infection in adults 21 May 2013Volume 158, Issue 10Page: 776KeywordsAntiretroviral therapyAntiretroviralsConflicts of interestDrug adherenceDrug safetyDrugsForecastingSafetySafety studiesSystematic reviews ePublished: 21 May 2013 Issue Published: 21 May 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...