POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: Nowandthen301 on January 21, 2017, 04:17:43 pm
-
I am seeing a lot of posts about newer drugs being recommended over Atripla due to side effects. I am also seeing post about this drugs effectivity when taking as little as three days a week.
Being that the drug will go off patent relatively soon am I correct to assume it potentially will provide the biggest return for the cost some point in the future?
Are researchers looking at lower doses for people who have remained undetectable for a certain period of time rather than taking the higher dose less frequently? I assume this lower dose would reduce side effects? Would this lower dose cause the drug's patent to be extended in the US?
Finally why are treatment cost not more often part of the discussion? I understand insurance covers most cost, but that only raises the price society pays for insurance and incentives drug companies to charge more (rightly or wrongly).
Sorry for all the loaded questions!
-
Hi
There are a number of drugs that have patents dropping including Truvada soon enough.
As for Atripla yeah its not routinely recommend as first choice anymore, there are more effective treatments for people and less side effects that said if your on Atripla and happy that is cool for you.
Are researchers looking at lower doses for people who have remained undetectable for a certain period of time rather than taking the higher dose less frequently? I assume this lower dose would reduce side effects? Would this lower dose cause the drug's patent to be extended in the US?
There are plenty of studies into bi therapy and even mono therapy ongoing with more modern meds, I suspect that the mid term future is down the bi therapy route, fewer side effects to start with and lower dosages, with more targeted modern drugs rather than looking at the older combinations and cutting the days.
SWORD Study - Tivicay (dolutegravir) and Edurant (rilpivirine)
GEMINI trial - dual therapy with dolutegravir plus lamivudine
That said it has been looked at:
https://www.poz.com/article/may-possible-take-atripla-just-three-times-week
Cost of treatment is often a discussion, be it separate from the discussion of side effects etc. Generic drugs and the switch to them for example is something often discussed when talking about PrEP. I suppose it all depends who your talking to.
On the forum we have a few threads about the costs and also costs of generic drugs as part of the insurance & benefits topic https://forums.poz.com/index.php?board=27.0 Feel free to read and/or open a thread in that section if you want to talk about the costs.
Jim
-
Are researchers looking at lower doses for people who have remained undetectable for a certain period of time rather than taking the higher dose less frequently?
Yes... WHO has approved EFV 400 mg; hence Cipla has annouced a replacement pill, currently known as TLE-400
(Tenofovir/Lamivudine/Evafirenz 400 mg)
the press release is here:
http://www.prnewswire.com/news-releases/on-world-aids-day-mylan-announces-plans-to-be-the-first-to-market-newly-recommended-antiretroviral-treatment-for-99-per-patient-per-year-300186205.html
Will it be available every where ? I doudt so, but we will see. Since the press relaese, I haven't found anything new.
Alternatively to dosage reduction, there has been a few trials using the standard 600mg with less frequent dosing; in the US the strategy is named FOTO and is detailed here: (BTW, I am using it, but not with Efavirenz found in Atripla)
http://crine.org/our-research/research-network/foto/
For the other trials, you will have to google somewhat.