Gilead has priced its STRIBILD at $28,500 / year. The other two single tablet HIV regimens, Complera and Atripla cost $26, 350 /year and $24,971.64/year, respectively.
A regimen of twice a day raltegravir (Isentress) plus once a day Truvada costs $30,753 /year. Boosted Reyataz plus Truvada costs $34,390/year and boosted Prezista plus Truvada is $35,148/year.
Currently, Atripla, boosted Reyataz plus Truvada, boosted Prezista plus Truvada, and Isentress plus Truvada are the preferred first line regimens by the US DHHS adult guidelines panel. Complera is an alternative regimen not yet considered “preferred” . The fate of Stribild as a preferred or alternative regimen has not been determined by the guidelines panel yet.
Cost is not a factor in considering a regimen preferred or alternative. Only drug efficacy, side effects and quality of the data are considered. But some countries in Europe are already taking cost into consideration in recommending first line regimens. Will that be a consideration in the United States? As HIV first line therapy options increase and US health care costs are curtailed , the European trend may spread to the United States. We will have to wait to see what happens.
A regimen of twice a day raltegravir (Isentress) plus once a day Truvada costs $30,753 /year. Boosted Reyataz plus Truvada costs $34,390/year and boosted Prezista plus Truvada is $35,148/year.
Currently, Atripla, boosted Reyataz plus Truvada, boosted Prezista plus Truvada, and Isentress plus Truvada are the preferred first line regimens by the US DHHS adult guidelines panel. Complera is an alternative regimen not yet considered “preferred” . The fate of Stribild as a preferred or alternative regimen has not been determined by the guidelines panel yet.
Cost is not a factor in considering a regimen preferred or alternative. Only drug efficacy, side effects and quality of the data are considered. But some countries in Europe are already taking cost into consideration in recommending first line regimens. Will that be a consideration in the United States? As HIV first line therapy options increase and US health care costs are curtailed , the European trend may spread to the United States. We will have to wait to see what happens.
Read what activists are doing: https://www.aidsmeds.com/articles/hiv_stribild_cost_1667_22878.shtml
The following tables come from: https://www.aidsinfo.nih.gov/contentfiles/lvguidelines/aa_tables.pdf
Appendix C, Table 1. Monthly Average Wholesale Pricea of Antiretroviral Drugs
(Last updated March
27, 2012; last reviewed March
27,
2012) (page 1 of 2)
27,
2012) (page 1 of 2)
|
Antiretroviral Drug
Generic (Brand) Name
|
Strength
|
Dosing
|
Tabs/Capsules/
mLs per Month
|
AWPa
(Monthly)
|
|
Nucleoside Reverse
Transcriptase Inhibitors (NRTIs) |
||||
|
abacavir (Ziagen)
|
300-mg tab
20-mg/mL soln
|
2 tabs daily
30 mLs daily
|
60 tabs
900 mL
|
$641.50
$674.60
|
|
didanosine DR (generic product) (Videx EC)
|
400-mg cap
400-mg cap
|
1 cap daily
1 cap daily
|
30 caps (≥ 60 kg)
30 caps (≥ 60 kg)
|
$368.72
$460.14
|
|
emtricitabine (Emtriva)
|
200-mg cap
|
1 cap daily
|
30 tabs
|
$504.37
|
|
lamivudine (generic) (Epivir)
(Epivir)
|
300-mg tab
300-mg tab
10-mg/mL soln
|
1 tab daily
1 tab daily
30 mL daily
|
30 tabs
30 tabs
900 mL
|
$429.66
$477.41
$509.28
|
|
stavudine (generic) (Zerit)
|
40-mg cap
40-mg cap
|
1 cap twice daily
1 cap twice daily
|
60 caps
60 caps
|
$411.16
$493.38
|
|
tenofovir (Viread)
|
300-mg tab
|
1 tab daily
|
30 tabs
|
$873.28
|
|
zidovudine (generic) (Retrovir)
|
300-mg tab
300-mg tab
|
1 tab twice daily
1 tab twice daily
|
60 tabs
60 tabs
|
$360.97
$557.83
|
|
Non-nucleoside Reverse
Transcriptase Inhibitors (NNRTIs) |
||||
|
delavirdine (Rescriptor)
|
200-mg tab
|
2 tabs three times daily
|
180 tabs
|
$365.45
|
|
efavirenz (Sustiva)
|
200-mg cap
600-mg tab
|
3 caps daily
1 tab daily
|
90 caps
30 tabs
|
$689.52
$689.52
|
|
etravirine (Intelence)
|
100-mg tab
200-mg tab
|
2 tabs twice daily
1 tab twice daily
|
120 tabs
60 tabs
|
$978.64
$978.64
|
|
nevirapine (Viramune)
nevirapine XR (Viramune XR)
|
200-mg tab
400-mg tab
|
1 tab twice
daily
1 tab daily
|
60 tabs
30 tabs
|
$723.08
$632.68
|
|
rilpivirine (Edurant)
|
25-mg tab
|
1 tab daily
|
30 tabs
|
$804.38
|
|
Protease Inhibitors (PIs)
|
||||
|
atazanavir (Reyataz)
|
150-mg capb
200-mg cap
300-mg capb
|
2 caps daily
2 caps daily
1 cap daily
|
60 caps
60 caps
30 caps
|
$1,176.23
$1,176.23
$1,165.12
|
|
darunavir (Prezista)
|
400-mg tabb
600-mg tabb
|
2 tabs daily
1 tab twice
daily |
60 tabs
60 tabs
|
$1,230.20
$1,230.20
|
|
fosamprenavir (Lexiva)
|
700-mg tab
|
2 tabs twice daily
1 tab twice dailyb
2 tabs once dailyb
|
120 tabs
60 tabs
60 tabs
|
$1,812.68
$906.34
$906.34
|
|
indinavir (Crixivan)
|
400-mg cap
|
2 caps three
times daily
2 caps twice
dailyb |
180 caps
120 caps
|
$548.12
$365.41
|
|
nelfinavir (Viracept)
|
625-mg tab
|
2 tabs twice daily
|
120 tabs
|
$879.84
|
|
ritonavir (Norvir)
|
100-mg tab
|
1 tab once daily
1 tab twice daily
2 tabs twice daily
|
30 tabs
60 tabs
120 tabs
|
$308.60
$617.20
$1,234.40
|
Appendix C, Table 1. Monthly Average Wholesale Pricea of Antiretroviral Drugs(Last updated March
27, 2012; last reviewed
March 27, 2012) (page 2
of 2)
March 27, 2012) (page 2
of 2)
|
Antiretroviral Drug
Generic (Brand) Name
|
Strength
|
Dosing
|
Tabs/Capsules/
mLs per Month
|
AWPa
(Monthly)
|
|
saquinavir (Invirase)
|
500-mg tabb
|
2 tabs twice daily
|
120 tabs
|
$1,088.84
|
|
tipranavir (Aptivus)
|
250-mg capb
|
2 caps twice daily
|
120 caps
|
$1,335.14
|
|
Integrase Strand Transfer Inhibitor (INSTI)
|
||||
|
raltegravir (Isentress)
|
400-mg tab
|
1 tab twice daily
|
60 tabs
|
$1,171.30
|
|
Fusion Inhibitor
|
||||
|
enfuviritide (Fuzeon)
|
90-mg inj kit
|
1 inj twice daily
|
60 doses
(1 kit)
|
$3,248.72
|
|
CCR5 Antagonist
|
||||
|
maraviroc (Selzentry)
|
150-mg tab
300-mg tab
|
1 tab twice daily
1 tab twice daily
|
60 tabs
60 tabs
|
$1,148.16
$1,148.16
|
|
Coformulated Combination Antiretroviral Drugs
|
||||
|
abacavir/lamivudine (Epzicom)
|
600/300-mg tab
|
1 tab daily
|
30 tabs
|
$1,118.90
|
|
tenofovir/emtricitabine (Truvada)
|
300/150-mg tab
|
1 tab daily
|
30 tabs
|
$1,391.45
|
|
zidovudine/lamivudine (generic) (Combivir)
|
300/150-mg tab
300/150-mg tab
|
1 tab twice daily
1 tab twice daily
|
60 tabs
60 tabs
|
$931.61
$1,035.12
|
|
abacavir/lamivudine/zidovudine
(Trizivir)
|
600/150/300-mg
tab |
1 tab twice daily
|
60 tabs
|
$1,676.62
|
|
lopinavir/ritonavir (Kaletra)
|
200 mg/50-mg tab
400 mg/100 mg per
5-mL soln
|
2 tabs twice
daily or
4 tabs once
daily
5 mL twice daily
|
120 tabs
300 mL
|
$871.36
$871.34
|
|
rilpivirine/tenofovir/emtricitabine
(Complera)
|
200/25/300 mg
|
1 tab daily
|
30 tabs
|
$2,195.83
|
|
efavirenz/tenofovir/emtricitabine
(Atripla)
|
300/200/600 mg
|
1 tab daily
|
30 tabs
|
$2,080.97
|
a AWP = Average
Wholesale Price in 2012 (source: First DataBank
Blue Book AWP, accessed January 2012) Note that this price may not represent the pharmacy acquisition price or the price paid by consumers.
Wholesale Price in 2012 (source: First DataBank
Blue Book AWP, accessed January 2012) Note that this price may not represent the pharmacy acquisition price or the price paid by consumers.
b Should
be used in combination with ritonavir.
Please refer to Appendix B, Table 3 for ritonavir doses.
be used in combination with ritonavir.
Please refer to Appendix B, Table 3 for ritonavir doses.
Key to Abbreviations: AWP = average wholesale
price; cap = capsule,
DR = delayed release, EC = enteric
coated, inj = injection, soln = solution, tab = tablet, XR = extended release
price; cap = capsule,
DR = delayed release, EC = enteric
coated, inj = injection, soln = solution, tab = tablet, XR = extended release