Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
Reuters NewMedia, Inc. - Wednesday September 10 6:21 PM EDT
Leslie Gevirtz
What the studies in Thursday's New England Journal of Medicine did not address was how most of the millions of people around the world infected with the human immunodeficiency virus could afford the estimated $10,000 to $12,000 annual treatment.
The three drugs involved in the ``cocktail'' are: indinavir, sold under the brand name Crixivan by Merck & Co. Inc. (MRK); lamivudine, sold as Epivir or 3TC by Glaxo-Wellcome Plc (GLXO.L) and another Glaxo product, AZT, known as zidovudine or Retrovir.
Glaxo did not return phone calls seeking comment or price information, but Dr. Roy Gulick who headed one of the studies, told reporters he estimated the treatment costs at $10,000 to $12,000 annually.
Fewer than one-third of the estimated 650,000 to 900,000 people infected with HIV in the United States are currently taking a protease inhibitor such as Crixivan, Merck noted in a statement.
Merck said the annual cost for Crixivan is $4,380 annually, which the pharmaceutical company said was a quarter to one-third less than the three other protease inhibitors on the market. A Merck spokesman said the high cost of drug development and processing was to blame for the high price.
Meanwhile, more than half of the 50 state AIDS Drug Assistance Programs are imposing limits to cope with growing demands and costs for drug therapies such as those studied, according to a Washington, D.C.-based advocacy group.
Some 35 states have enacted emergency cost-containment measures in the last year including instituting waiting lists, restricting access to protease inhibitors, capping the number of patients served, reducing the number of drugs covered and restricting eligibility by lowering income levels, said the ADAP working group.
In the National Institutes of Health study of 1,156 patients, which mirrored the U.S. AIDS population, the research team headed by Dr. Scott Hammer of Harvard Medical School found that about one third of those taking only AZT and lamivudine saw their disease progress to AIDS. But only 6 percent of those taking the three-drug combination reached the medical definition of AIDS.
In the NIH study, the drug stavudine, sold under the brand name Zerit by Bristol-Myers Squibb (BMY) was sometimes substituted for AZT. Bristol-Myers said Zerit costs $3,044 wholesale annually per patient, about the same as 3TC and 10 percent less than AZT.
The second study, led by Dr. Gulick of the New York University School of Medicine, tallied the number of AIDS virus particles in a standard sample of blood.
In 90 percent of the volunteers getting all three drugs, the number of virus particles dropped sharply. The same level of decline occurred in only 43 percent of the people getting indinavir and none of the subjects who got a combination of AZT and lamivudine.
Doctors believe that when fewer virus particles can be detected in the blood, the person will live longer and be less prone to AIDS-related infections.
The benefits of the treatment persisted for as long as a year, the Gulick team said. In the past, HIV has developed resistance to the drugs used to fight it.
970910
RE970903
Copyright © 1997 - Reuters, Ltd. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Contact Reuters.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, the National Library of Medicine, Pacific Life Foundation and donations from users like you.
Always watch for outdated information. This article first appeared in 1997. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 1997. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .