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Province to pay for three-in-one HIV pill

New drug combines standard medicines

Ontario has decided to pay for a combination HIV treatment that could make patients’ lives a lot easier.

The Ontario Drug Benefit (ODB) program will list Atripla, meaning the cost of the drug will be covered for those receiving treatment for HIV. Atripla is one pill that combines the drugs Sustiva and Truvada. Truvada itself is a combination of Viread and Emtriva.

David Fletcher, a doctor at Toronto’s Maple Leaf Medical Clinic and the director of the clinic’s HIV/Hepatitis C Preceptorship Program, told a press conference that the convenience of one pill would make a considerable difference to many people with HIV.

“It’s the first drug that has three medications in one pill once a day,” he said. “It helps people stay on their therapy long-term because it’s convenient. People tend to forget one pill or another or run out of one bottle sooner.”

Fletcher said the drugs have been commonly prescribed together since 2001.

“It’s indicated for almost anyone with HIV,” he said at the conference, put on by pharmaceutical company Bristol-Myers Squibb Canada, which manufactures Atripla. “It’s a very popular treatment for newly diagnosed patients. It’s quite durable in its ability to fight HIV and keep people well.”

Until now most patients have been prescribed Sustiva and Truvada separately, as each drug was covered by ODB. Atripla was approved by Health Canada in October 2007, meaning it was available in Ontario but only at a cost of $40 a day.

Atripla has also been listed in British Columbia, Alberta and Quebec.

Robin Rhodes, the HIV health promotion coordinator at the AIDS Committee of Toronto (ACT), says he welcomes access to Atripla.

“It’s so much easier for clients to manage the daily regime,” he says. “From hat we understand it’s been well received.”

Rhodes says the pill will be especially helpful in reducing scheduling complications for those who are on other medications as well.

“If they’re taking three other medications and some have to be taken with food and some without, if they can just take this pill at any time, with food or without, it doesn’t need refrigeration, it’ll be much easier just in terms of practical day-to-day living.”

Fletcher did warn the press conference about side effects.

“Early on up to 50 percent can get abnormalities with their sleep, vivid dreams, a little dizziness,” he said. “Ninety-eight percent get over it in a few weeks. Longer term you can rarely get depression or anxiety, sleep disorders and very rarely you can have kidney disorders. Very few people need to discontinue this medication.”

Fletcher said not everybody will be able to take Atripla.

“People with HIV often have other things going on, like high blood pressure,” he said. “If you have low kidney function, you don’t take it. If you’re a pregnant woman or a woman wanting to become pregnant, if you’ve ever been on these drugs and had an allergic reaction, if you’re on other drugs for cancer, if you have a resistant [HIV] virus, you can’t take it.”

Fletcher said Atripla is in no way a miracle drug.

“This drug is not a cure for HIV,” he said. “It doesn’t work for everything. There are resistant viruses. You can still transmit HIV. It’s no replacement for a condom.”

Rhodes says a number of clients at ACT are interested.

“The consensus is, ‘This looks interesting, I’ll discuss it with my doctor,'” he says.

Rhodes says the most welcome part of Atripla for him is the fact that its development required a partnership between Bristol-Myers, which makes Sustiva, and Gilead Sciences, which makes Truvada. The joint research on Atripla began in 2004.

“It’s wonderful to see two major pharmaceutical companies coming together in a major development,” he says. “I really welcome this sort of development.”