Department set to extend AIDS drug tender
The Department of Health plans to extend the AIDS drug tender to ensure that pharmaceutical manufacturers are ready to compete on supplying the new “wonder drug” dolutegravir, a cheaper and safer alternative to one of the components now used in the three-drug cocktail provided by state institutions to most HIV patients.
The tender, valued at R14bn when it was announced in January 2015, was originally scheduled to end in March 2018.
Bids for the new tender would be called for once a sufficient number of generic dolutegravir products were registered with the Medicines Control Council to ensure vigorous competition, Anban Pillay, the health department’s deputy director-general for regulation and compliance, told a joint sitting of Parliament’s portfolio committees on economic development and health on Wednesday. “It will be significant for patients and save us money.”
SA has the largest HIV treatment programme in the world. The programme reaches about 3.5-million patients. More than 75% of the costs are borne by the government, in stark contrast to many other high-burden countries, which depend more heavily on donor support.
Cutting the price of treatment is vital if the government is to achieve its goal of expanding access to treatment to everyone who needs it and ensuring patients begin treatment as soon as they are diagnosed.
GlaxoSmithKline is at present the sole supplier of dolutegravir in SA and its two products, Tivicay and Trelavue, are available only in the private sector. Tivicay contains dolutegravir alone and will cost a patient more than R850 a month, while Trelavue contains dolutegravir, lamivudine and abacavir and carries a price tag of more than R1,000 a month.
Although several generic drug manufacturers had been awarded voluntary licences to manufacture cheaper versions of dolutegravir under an agreement with the Medicines Patent Pool, to date, none had had its products approved by the Medicines Control Council, several sources confirmed.
Most HIV patients on firstline therapy take efavirenz combined with tenofovir and emtricitabine. But efavirenz is vulnerable to resistance and can cause side effects.
Once the tender is awarded, the plan is to replace efavirenz with dolutegravir.
Aspen Pharmacare said the extension of the tender would be neutral for the company. Aspen had a dolutegravir product, but it had yet to be approved by the council, said strategic trade head Stavros Nicolaou.