Publications & Reports

Reaching UNAIDS 95-95-95 targets worldwide: predicted benefits and treatment costs with generic manufacture.

Heath K, Levi J, Hill A
Burnet Institute, 85 Commercial Road, Melbourne, 3004 VIC, Australia Accident and Emergency Medicine, Homerton Row, Clapton, London, E9 6SR, UK Department of Translational Medicine, University of Liverpool, Liverpool, L69 3BX, UK.


BACKGROUND: UNAIDS aims for HIV testing, treatment and viral suppression rates to be 95%-95%-95% by 2025. Patented drug prices remain a barrier to HIV treatment. Generic alternatives are being produced and exported from countries without patent barriers at a fraction of the cost. METHODS: We collated export records of active pharmaceutical ingredient for HIV drugs to estimate the minimum costs of production. Using epidemiological data describing national HIV epidemics, we calculated the cost to treat 164 countries at 95%-95%-95%. Using weighted log-linear regression models we estimated the mother-to-child transmissions (MTCTs), HIV-related deaths and new HIV infections preventable every year by increased treatment. FINDINGS: We estimated that TDF/3TC/DTG could be produced for $59 per person per year. At this price, the 164 countries in our analysis could be treated at 95%-95%-95% for $2 billion a year, preventing 66,308 MTCTs, 241,811 HIV-related deaths and 631,398 new HIV infections every year. In comparison, global expenditure on HIV pharmaceuticals in 2019 was $28 billion. INTERPRETATION: At $2 billion/year, the 164 countries in our analysis could be treated for the price of four weeks of current global sales. Global access to generic alternatives could reduce expenditure and improve clinical outcomes.

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  • Journal: AIDS
  • Published: 09/06/2021
  • Volume: 35
  • Issue: Suppl 2
  • Pagination: S197-S203