Doctors decry cost-cutting in HIV treatment
pharmafile | November 2, 2011 | News story | Sales and Marketing | HIV, NHS, Reyataz
Doctors in London are opposing a decision to switch HIV patients to a cheaper drug, saying it could harm patients.
Health service commissioners in London have negotiated a discount with Bristol-Myers Squibb’s for its antiretroviral Reyataz (atazanavir), which will see some patients switched from their current HIV treatments to make savings.
The London HIV Consortium is responsible for the capital’s HIV services, and has been asked to find £8 million in savings over the next two years.
But some doctors have come out against the decision, saying it raises ethical issues and could create unnecessary health risks. An anonymous HIV specialist told the BBC that using Reyataz instead of higher priced treatments could be detrimental to some patients.
He says Merck’s Isentress (raltegravir) is an antiretroviral drug “that everyone wants access to, because it has few side-effects.”
He added: “That’s entirely down to cost pressures,” he said, and warned it could create the return of postcode prescribing, as Isentress “would [now] be easier to get outside London”.
There are over 25,000 HIV positive patients on antiretroviral drugs (ARVs) in London, with up to 3,000 more starting treatment each year. London’s NHS spent over £170 million on ARVs last year, and costs are expected to rise because of a growing incidence of HIV in the capital.
Switch only when ‘clinically appropriate’
The London Specialised Commissioning Group (LSCG) is the body which commissions from The London HIV Consortium. It said in a statement: “The ARV tender process this year means that considerable savings will be made to the bill for antiretrovirals, and these savings will be used to improve HIV services and pay for optimal treatment for all HIV infected individuals.”
It stressed that patients would not be put at risk by the switch, and would only be done where clinically appropriate.
“HIV doctors will continue to ensure treatment is tailored to the needs of the individual patient and, where it is clinically appropriate to do so, will use the least expensive treatment option available.
“If the least expensive drugs are not clinically appropriate for a patient, then HIV doctors will select a different treatment that will keep the patient well and reduce their viral load to undetectable levels,” the Group said.
It said the decision is in line with the Quality, Innovation, Productivity and Prevention (QIPP) agenda, aimed at saving £20 billion across the NHS by 2015.
Ben Adams
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