[Ip-health] MSF: High prices hinder access to newer HIV drugs and optimal tests that ensure treatment is working

Joanna Keenan-Siciliano joanna.l.keenan at gmail.com
Mon Jul 21 01:14:24 PDT 2014

*High prices hinder access to newer HIV drugs and optimal tests that ensure
treatment is working*


*Melbourne, 21 July 2014* – High prices continue to represent a major
barrier to affordable access of both new HIV medicines and viral load
testing -- which is the best way to monitor whether treatment is working --
according to two reports released today by international medical
humanitarian organisation Médecins Sans Frontières (MSF).

Scaling up HIV treatment to reach more people in need – and ensuring
successful treatment in suppressing the virus – will require concerted
actions by countries to make these critical tools more affordable.

“Nearly 12 million people are now receiving antiretroviral therapy (ART) in
developing countries”, said Dr Jennifer Cohn, Medical Director of MSF’s
Access Campaign. “With people increasingly starting treatment earlier and
remaining on treatment for life, patients need better-tolerated first-line
treatments as well as affordable second line-therapy for when first-line
medicines fail.”

Additional tools to support treatment are needed to ensure the best quality
of care. Routine viral load monitoring - which measures the level of HIV
virus in the blood, and therefore how well someone is responding to
treatment – is one of these tools.

“Viral load monitoring detects adherence problems early which, when paired
with counselling and support, can help people stay on more affordable
first-line treatment for longer”, said Dr Jennifer Cohn, Medical Director
of MSF’s Access Campaign. “Viral load monitoring also more accurately and
rapidly identifies those people who need to be switched to second- or
third-line treatment if their existing regimen is failing.”

The new MSF report *Getting to Undetectable*, which describes access to
viral load testing in India, Kenya, Malawi, South Africa and Zimbabwe,
reveals that while these countries aspire to implement routine viral load
monitoring, almost none have been able to do this on a wide scale. The
report concludes that, among other barriers, the price per test paid by
countries is a major obstacle to wider implementation.

The report also outlines steps that countries can take to reduce the cost
and complexity of introducing viral load monitoring, including better price
negotiation, renting instruments instead of buying them, dropping the more
common, but less accurate, CD4 monitoring, and using more efficient sample
collection techniques. These steps have been successful in some countries;
negotiations have already resulted in price decreases for viral load, with
Kenya paying about US$10 per test. Donors however, need to step up to the
plate and provide financing for rolling out viral load in those areas that
need it most.

 “We know what tools we need to use to help ensure people’s HIV virus can
get to undetectable and stay there”, said Dr Cohn. “But in most of our
contexts, they’re priced out of reach.”

Although roll-out of viral load is slow and incomplete, it is expected to
uncover many people who are failing first-line treatment and need to be
switched to second-line. Thus, the price of drugs for second-line therapy
becomes a critical issue.

MSF’s annual drug pricing report, *Untangling the Web of Antiretroviral
Price Reductions*, this year concludes that, while the cost of first- and
most second-line regimens have fallen over the last 12 months, second-line
regimens are still more than double the cost of first-line treatment. For
middle-income countries the situation is worse, with some countries paying
over 12 times more than the lowest known price.

“There are millions of people without access to treatment, and many of
those on treatment need to be switched to newer regimens”, said Leena
Menghaney, Manager of MSF’s Access Campaign in India. “If we are to get
more people on treatment now, countries need to overcome patent barriers
that undermine affordable access to drugs.”

- ends -


*MSF Access Campaign publications *

*Untangling the Web of Antiretroviral Price Reductions, **17th edition*

*www.msfaccess.org/utw17 <http://www.msfaccess.org/utw17>*

Over the past 14 years, the MSF Access Campaign has been monitoring the
patent barriers,

prices and availability of ARVs through *Untangling the Web* and pushing
for the uptake of

policies that promote access to affordable quality medicines.

*Getting to Undetectable: Usage of HIV Viral Load Monitoring in Five

This issue brief is the fifth in a series produced by MSF to equip
policymakers, people living with HIV/AIDS, and communities with information
on the products, costs, and operational strategies to help realise scale-up
of viral load monitoring, which we believe is an essential tool, along with
adherence support, to help as many people on ART as possible to reach and
maintain viral suppression.

Report:  *http://www.msfaccess.org/content/usage-hiv-viral-load-monitoring-5-countries

Full series of Undetectable reports: *http://www.msfaccess.org/undetectable

Joanna Keenan
Press Officer
Médecins Sans Frontières - Access Campaign
P: +41 22 849 87 45
M: +41 79 203 13 02
E: joanna.keenan[at]geneva.msf.org
T: @joanna_keenan


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