Breaking Up Is Hard to Do | Physician & Payer Forum | US | 2015

How Will the Availability of Generic Antiretrovirals Impact the Uptake of Branded Single-Tablet Regimens in the United States?

The availability of once-daily single-tablet regimens (STRs) with high efficacy and good safety profiles has transformed HIV into a manageable chronic illness for most patients. However, the need for expensive, daily, lifelong antiretroviral (ARV) therapy can place a considerable cost burden on insurance providers. As a result, the eminent availability of generic versions of components in heavily prescribed regimens may force prescribing physicians to “break up” STRs and shift prescriptions to multi-tablet regimens (MTRs) that incorporate generics.

This U.S. Physician & Payer Forum report explores dynamics that impact uptake of current and emerging ARV agents used for the management of HIV infections. In particular, this report assesses what impact, if any, payer-imposed cost-containment measures will have on physician uptake of branded STRs and other premium-priced ARV agents. In addition to the treatment of HIV infections, this report delves into physician use of Gilead’s Truvada (emtricitabine/tenofovir disoproxil fumarate [TDF]) as pre-exposure prophylaxis (PrEP) for the prevention of HIV infection. Truvada is currently the only FDA-approved ARV agent for use as PrEP. Our findings are based on survey responses from U.S. infectious disease (ID) specialists and U.S. managed care organization (MCO) pharmacy directors/medical directors (PDs/MDs).