Cost-Effectiveness of Generic Antiretroviral Therapy

Letters21 May 2013Cost-Effectiveness of Generic Antiretroviral TherapyRochelle P. Walensky, MD, MPH, A. David Paltiel, MBA, PhD, and Bruce R. Schackman, MBA, PhDRochelle P. Walensky, MD, MPHFrom Massachusetts General Hospital, Boston, Massachusetts; Yale School of Medicine, New Haven, Connecticut; and Weill Cornell Medical College, New York, New York.Search for more papers by this author, A. David Paltiel, MBA, PhDFrom Massachusetts General Hospital, Boston, Massachusetts; Yale School of Medicine, New Haven, Connecticut; and Weill Cornell Medical College, New York, New York.Search for more papers by this author, and Bruce R. Schackman, MBA, PhDFrom Massachusetts General Hospital, Boston, Massachusetts; Yale School of Medicine, New Haven, Connecticut; and Weill Cornell Medical College, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-10-201305210-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Hirnschall and de Joncheere provide important new information and a useful global context, both of which strengthen support for the once-daily, 3-pill formulation of generic efavirenz, generic lamivudine, and tenofovir that will soon be available in the United States. The World Health Organization review (1)—which was motivated by in vitro studies suggesting pharmacologic differences between emtricitabine and lamivudine that we noted—finds clinical equivalence between the 2 drugs. Because this result was not available when we conducted our analysis, we adopted a conservative approach, assigning the branded formulation a small efficacy advantage. Despite our deliberate bias against it, ...Reference1. 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 Scholar Author, Article, and Disclosure InformationAuthors: Rochelle P. Walensky, MD, MPH; A. David Paltiel, MBA, PhD; Bruce R. Schackman, MBA, PhDAffiliations: From Massachusetts General Hospital, Boston, Massachusetts; Yale School of Medicine, New Haven, Connecticut; and Weill Cornell Medical College, New York, New York.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1790. 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 Gottfried Hirnschall and Cornelis de Joncheere Metrics Cited byDe-simplifying single-tablet antiretroviral treatments for cost savings in France: From the patient perspectives to a 6-month follow-up on genericsGeneric antiretroviral drugs and HIV care: An economic reviewLower prevalence of drug resistance mutations at first-line virological failure to first-line therapy with atripla vs. tenofovir + emtricitabine/lamivudine + efavirenz administered on a multiple tablet therapySystematic review and meta-analysis: Patient and programme impact of fixed-dose combination antiretroviral therapyComparative Efficacy of Lamivudine and Emtricitabine: A Systematic Review and Meta-Analysis of Randomized Trials 21 May 2013Volume 158, Issue 10Page: 776-777KeywordsAntiretroviral therapyConflicts of interestDisclosureDrugsGlobal health ePublished: 21 May 2013 Issue Published: 21 May 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...