The potential savings from prescribing generic antiretrovirals predicted by economic models may be overstated and numerous barriers need to be overcome to bring down the cost of HIV treatment in higher-income countries, according to the findings of several recently-published analyses.
Switching to cheaper generic versions of some antiretrovirals has been proposed as a means of freeing up money to treat more people with HIV in the United States and other higher-income countries where generics are beginning to become available. One modelling study estimated that nearly $1 billion would be saved in a single year if everyone taking Atripla (efavirenz/tenofovir/emtricitabine) switched to generic efavirenz and lamivudine plus branded tenofovir (Viread).
But in an article for the New England Journal of Medicine, Erika Martin of the State University of New York and Bruce Schackman of Weill Cornell Medical College identify a number of barriers that stand in the way of the more optimistic scenarios.
Scepticism among healthcare providers, patients and pharmacists about the safety and efficacy of generic medications is an important barrier, the authors say. A systematic review of studies of perceptions of generic medications in the general population found that around one in three lay people viewed generic medicines as...