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"The switch from branded to generic antiretrovirals would place us in the uncomfortable position of trading some losses of both quality and quantity of life for a large potential dollar savings.
By estimating the likely magnitude of these offsetting effects now - before generic antiretrovirals actually hit the shelves - we can confront our willingness as clinicians, patients and as a society to make these difficult choices."
"Diverting patients from the most effective, branded treatment alternative could be made more acceptable if the savings were directed to other HIV-related needs. For example, fewer than half the state-funded AIDS Drug Assistance Programs include the effective protease-inhibitor-based treatment for hepatitis C virus (HCV), which infects up to 25 percent of HIV-infected individuals. We calculated that, for every 15 patients switched to the generic-based regimen, one who is also infected with HCV could be treated and potentially cured of that infection."
"There's no getting around the fact that savings from generics will only be realized if we deliberately route patients away from the most effective, branded treatment alternative," she stresses. "This is a trade-off that many of us will find emotionally difficult, and perhaps even ethically impossible, to recommend. All of us - consumers, providers and advocates - would be far likelier to embrace such a policy change if we knew the savings would be redirected towards other aspects of HIV medicine."
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Not to be reproduced without the permission of Medical News Today.
Rochelle P. Walensky, MD, MPH; Paul E. Sax, MD; Yoriko M. Nakamura, BA; Milton C. Weinstein, PhD; Pamela P. Pei, PhD; Kenneth A. Freedberg, MD, MSc; A. David Paltiel, PhD; and Bruce R. Schackman, PhD
Ann Intern Med. 15 January 2013;158(2):84-92
Economic Savings Versus Health Losses: The Cost-Effectiveness of Generic Antiretroviral Therapy in the United States
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10 Dec. 2013. <http://www.medicalnewstoday.com/articles/254972>
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