Multi-resistant HIV strains prompt new funding

Two newly funded medicines will help the fight against drug-resistant strains of the human immunodeficiency virus (HIV) in a multi-product deal that will also help fight infections in hospitals.

PHARMAC will fund darunavir (Prezista) and etravirine (Intelence) as part of a multi-product agreement with Janssen-Cilag from 1 November 2010. Both darunavir and etravirine are antiretroviral drugs used to combat HIV, the infection that can lead to AIDS.

PHARMAC Medical Director Dr Peter Moodie says the drugs are welcome additions to the range of funded HIV treatments as the disease becomes resistant to other forms of antiviral treatment.

“Recent advances in drug therapy have seen HIV infection become largely a chronic condition that many people live with,” says Dr Moodie. “However, we are now seeing strains of HIV that are resistant to multiple drug therapies. This makes the disease increasingly difficult to treat, and underscores the need for further treatment options.”

Dr Moodie says finding the right combination of antiviral therapies for each patient is the key to combating HIV. Etravirine is most effective when used in combination with darunavir. And darunavir can also be effective when combined with another recently-funded treatment, raltegravir, in patients who have already undergone extensive treatment.

The funding for darunavir and etravirine is the latest step PHARMAC has taken to improve access to HIV treatments in recent years. Other recent steps have included funding raltegravir, and providing funded access to quadruple therapy (combinations of up to four antiviral drugs).

“Funding new medicines such as darunavir and etravirine, and other steps we have taken in recent months, gives doctors treating HIV patients further opportunity to `customise’ the patient’s treatment and to find the optimal combination of treatments for controlling the disease,” says Dr Moodie.

The agreement with Janssen-Cilag includes two other products – an antibiotic used mainly in hospitals (dopinem), and the ADHD treatment methylphenidate (Concerta).

PHARMAC currently funds 17 HIV treatments (including combination products) in five drug categories. In the year to June 2010, spending on these treatments was $17.8 million. The new agreement will lead to estimated new spending of $1.6 million over the next five years.