POLAND: Eastern Europe Urged to Prepare Now for Growing Threat of HIV Resistance

Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

POLAND: Eastern Europe Urged to Prepare Now for Growing Threat of HIV Resistance

AIDS Weekly (11.17.03) - Wednesday, December 24, 2003

Experts at an HIV congress in Warsaw heard that Fuzeon (enfuvirtide, formerly T-20) is a valuable tool for both patient and payer in the fight against HIV drug resistance. It is especially helpful when used earlier in pretreated patients.

John Bowis, OBE, member of the European Parliament, applauded Poland's Ministry of Health for taking a proactive role in the fight against HIV and drug resistance. "The growing problem of HIV resistance is a serious issue which all members of the EU have a responsibility to manage. We must commit to share knowledge, particularly those countries more experienced in tackling the HIV epidemic, in an effort to provide a consistent standard of care and avert a potential health care crisis. We need to ensure that all European countries are benefiting from new treatments and are allocating vital resources where they will be of most value," he said.

Increasing HIV drug resistance means the first three classes of HIV drugs no longer help many patients. Unlike drugs that act inside the cell once it has been infected, Fuzeon works on the outside, actively blocking the fusion of the virus with CD4 cells. Because of its different mechanism of action, Fuzeon works against HIV strains that have become resistant to conventional therapies.

Pretreated patients with Fuzeon in their regimen were found to be twice as likely to achieve a reduction in HIV to undetectable levels as those not taking it. Based on the reduction in HIV and increase in CD4 cell count Fuzeon produces, scientists project that Fuzeon plus an optimized background regimen can increase patient survival an additional 1.6 years compared to an optimized background regimen alone.

Doctors and health economists presented a new evaluation in Warsaw showing Fuzeon to be cost-effective in pretreated HIV- positive patients studied in Phase III trials. A cost- effectiveness ratio of 30,000 pounds (US$53,188) per quality adjusted life year is considered a good value for the money. Fuzeon, when used as part of an optimized regimen, is a cost- effective treatment with an additional cost per QALY of roughly 23,200 pounds (US$41,131) compared to conventional optimized background therapy alone. Fuzeon was more cost- effective by as much as 8,000 pounds (US$14,182) when used earlier in patients in whom at least two other antiretroviral drugs are still active than when used later.

"The data... highlights not only the value of Fuzeon to health care professionals and health systems but the crucial importance that Fuzeon has for pretreated patients," said Dr. Mike Youle, director of HIV research at Royal Free Hospital, London. "We're talking about patients not only living longer but having increased quality of life through reduced side effects, allowing patients to get on with their everyday lives. We need to help patients return to work and to their families and friends."
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