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From: PlusNews <[email protected]>
Date: Fri, Nov 30, 2012 at 12:08 PM
Subject: SOUTH AFRICA: New ARV tender drops prices, changes treatment
To: Elisabeth Janaina <[email protected]>


SOUTH AFRICA: New ARV tender drops prices, changes treatment

JOHANNESBURG, 30 November 2012 (PLUSNEWS) - The South African
government has negotiated savings of about US$250 million in its
latest antiretroviral (ARV) tender, which is the first to include a
three-in-one tablet. This triple fixed-dose combination ARV will now
allow the country to move to new, simpler HIV treatment and prevention
of mother-to-child HIV transmission (PMTCT) guidelines in April 2013.

South Africa's newly announced tender, worth about US$672 million, is
the first to include a fixed-dose combination (FDC) ARV that, by
combining multiple pills into one, helps reduce patient pill burdens
and improve adherence. Under the new tender, an FDC containing
tenofovir, efavirenz and emtricitabine will be available to patients
starting in April.

Although doctors will be responsible for deciding which patients can
switch to the new FDC, Francesca Conradie, president of the HIV
Clinicians Society, estimates that at least 80 percent of the
country's ARV patients will be eligible to make the switch.

The FDC will now help the country roll-out new, simpler PMTCT
guidelines. From April, all HIV-positive expecting mums not already on
treatment will be started on the FDC during pregnancy and kept on the
drug combination until they stop breastfeeding, regardless of CD4
count - a measure of the immune system's strength.

Previously, only expecting mums with CD4 counts of 350 and below
started treatment. Those with higher CD4 counts received shorter, dual
ARV therapy to prevent vertical (mother-to-child) transmission of the
virus.

Prices come down

With an HIV prevalence of about 18 percent, South Africa runs the
world's largest HIV treatment programme. Its 1.7 million ARV patients
comprise 21 percent of the global market for the drugs, but the
country has only recently been able to begin to bring the costs of
these drugs down.

Before its 2010 ARV tender, the country - with the help of the Clinton
Health Access Initiative - negotiated a 53 percent reduction in drug
prices and saved the country almost US$250 million.
http://www.plusnews.org/Report/91406/SOUTH-AFRICA-New-ARV-tender-halves-drug-prices

With 2.5 million people expected to be on ARVs in the country by 2015,
policymakers had expected the tender to cost about 25 percent more
than the final price. According to Minister of Health Aaron
Motsoaledi, South Africa is now paying the lowest price for that
specific FDC of any country in the world.

"There's major benefits in terms of compliance, logistics and, we're
told by experts, that there are fewer side effects," Motsoaledi told
IRIN/PlusNews. "The FDC is more effective than dual therapy for
pregnant women. and because we'll be saving two billion rand in the
next two years, we can afford to treat more patients with the same
budget."

FDCs will now be provided by three companies - Aspen, Mylan and Cipla
Medpro - reflecting a trend within the tender towards multiple
suppliers, according to Motsoaledi. In 2011, the country experience
shortages of the ARV tenofovir after suppliers failed to meet demand;
this latest tender expands the number of suppliers to prevent a repeat
of this problem.

Conradie welcomed the second consecutive tender to slash ARV prices,
noting that the newly negotiated prices, which cut the costs of some
ARVs like tenofovir by almost 50 percent, were lower than she could
have dreamed.

"In this era of financial austerity, every rand must be seen as an
investment. Every rand spent on HIV must be used effectively," said
Catherine Sozi, the UNAIDS country director for South Africa, who
added that the move to FDCs is about more than money.

"One pill a day is better than an amalgamation of pills," she added.
"Now the delivery mode (of treatment) is rationalized, the regiment is
simplified and all of this is geared towards the country's primary
healthcare re-engineering policy."
http://www.plusnews.org/PrintReport.aspx?ReportID=95840

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[END]

This report online: http://www.plusnews.org/report.aspx?reportID=96930



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