[procaare] New AIDS Study Shows Efficacy of Cheaper Drug

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New AIDS Study Shows Efficacy of Cheaper Drug
Wall Street Journal - February 14, 2003
Vanessa Fuhrmans, Staff Reporter
http://ww2.aegis.org/news/wsj/2003/WJ030207.html
****************

In a finding that could bring some relief to cash-strapped
AIDS-drug assistance programs, a study shows a cheaper
antiretroviral drug works as well as its better-selling rival.

The 1,216-patient study, the first to compare the two drugs
directly, found that Viramune, an AIDS medicine that its maker
Boehringer Ingelheim GmbH sells at a U.S. wholesale price of
$366.94 for a month's supply, successfully suppressed AIDS virus
levels in 70% of those who took it over 48 weeks. That is the
same rate of success as Bristol-Myers Squibb Co.'s Sustiva, a
comparable drug that costs $449.64 a month.

Joep Lange, professor of internal medicine at the University of
Amsterdam, presented the data Friday at the 10th Conference on
Retroviruses and Opportunistic Infections in Boston. He conducted
the trial with the International Antiviral Therapy Evaluation
Center, an independent international group that conducts clinical
research on HIV treatments, though Boehringer Ingelheim sponsored
the study.

The finding could shift some of the market between the drugs,
particular in the U.S., where Sustiva is prescribed almost two
times as often as Viramune.

Both drugs are non-nucleoside reverse transcriptase inhibitors,
an alternative that requires fewer pills than the protease
inhibitors that revolutionized AIDS treatment in the mid-90s. But
Sustiva, launched in 1998, has been more aggressively promoted by
Bristol-Myers, and it has bigger studies backing it that suggest
better efficacy. The Department of Health and Human Services also
recommends it as the preferred drug in its class.

But the cost of treating AIDS has exploded in the past several
years, and programs that provide the drugs to more than 80,000
HIV-infected Americans without adequate health coverage are in a
budget crisis. More than 1,000 patients are on state-program
waiting lists for treatment because some have closed enrollment,
and the lists are getting longer.

Given a cheaper alternative for a key AIDS medicine, many state
programs may start encouraging Viramune instead, said William
Arnold, chair of the working group for state-run AIDS Drug
Assistance Programs, or ADAP.

"If people feel the efficacy is the same, there will be
implications," he said, adding that both ADAP and the Department
of Health review their recommendation lists on a regular basis
because of new clinical evidence.

"Even if programs don't make a change to their formularies, it
doesn't mean that, through the grapevine, there won't be some
nudging."

Professor Lange cautioned that the two drugs aren't as easily
interchangeable as allergy or headache medicines. There are many
reasons why a patient might not tolerate one drug or do better on
the other.

"What's reassuring is that doctors and patients know they have
alternatives," he said. "They don't have to worry that one might
not be as effective as the other."

Write to Vanessa Fuhrmans at vanessa.fuhrmans@wsj.com

030214
WJ030207

Copyright (c) 2003 - The Wall Street Journal. 

Source: 2003. AEGiS.
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