High Costs Prevent Vital HIV Treatments In Developing Countries, Research Reveals

Médecins Sans Frontières (MSF) reports that skyrocketing costs of HIV medicines and subsequent care prevents people in developing countries from having affordable access to vital care. The organization had called for scaled-up efforts to reach more people in need and to ensure successful treatments.

MSF’s annual drug pricing report, “Untangling the Web of Antiretroviral Price Reductions,” concluded 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.” It also found that the current situation is much worse for middle-income countries, with some having to pay over 12 times more than the lowest known price, MSF said in its press release.

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

Critical tools to support treatment  to ensure high-quality care to the nearly 12 million people currently receiving antiretroviral therapy (ART) in developing countries are not accessible. This inaccessibility is also carried over to the routine viral load monitoring—the process which measures the level of HIV virus in the blood—thus determining how well someone is responding to treatment.

The other report, Getting to Undetectable, which described access to viral load testing in countries like India Kenya, Malawi, South Africa, and Zimbabwe found the following:

• Most of the countries want to implement routine viral load monitoring, but almost none have been able to do this on a wide scale.
• The price per test paid by countries is a major obstacle to wider implementation.

It also highlighted steps to overcome these barriers, 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, according to MSF. In fact its ongoing negotiations have resulted in Kenya paying about $10 per test as well as facilitating decreases in other countries. But they also forewarn that in order to see more substantial changes for HIV treatments and care, donors will need to step up and provide the necessary funding.

“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.”