Body Positive applauds the recent injection of much needed funds into Pharmac to improve access to medications. New Zealand has fallen behind international standards in relation to the care of HIV and these additional funds provide an opportunity to move back to a world class health system and provide people with modern choices in the treatment of HIV.
In September 2015 the World Health Organisation (WHO) released treatment guidelines stating: Anyone infected with HIV should begin antiretroviral treatment as soon after diagnosis as possible. With its 'treat-all' recommendation, WHO removes all limitations on eligibility for antiretroviral therapy (ART) among people living with HIV; all populations and age groups are now eligible for treatment. This follows on from the START trial announcement on June 3rd providing the evidence to support early treatment to reduce transmission of HIV and provide improved long term health outcomes. New Zealand still requires people to wait until their immune system has been irreparably damaged by having their CD4 count fall below 500 before they are allowed to initiate therapy.
On April 9th 2015 the US treatment guidelines were released which shifted first line therapy to Integrase based combinations. Of the five primary regimens recommended only 2 are currently funded by Pharmac.
Most people prefer the simplicity of regimens requiring one pill once daily for treatment of HIV and this leads to better adherence. There are currently 6 one pill daily regimens available with 4 of these being approved for use in New Zealand but only one of them (Atripla) is currently funded. Atripla is 10 years old being introduced in the US in 2006. The new US guidelines downgrade Atripla from a recommended regimen to an alternative regimen for first line therapy based on its side effects that effect the central nervous system and that there are better alternatives with fewer side effects. Unfortunately these alternatives aren’t funded in New Zealand which limits people’s options.
For people newly diagnosed with HIV they are not allowed to access treatment until their immune system has been damaged • For people that are failing therapy their treatment options are limited which impacts their health • People returning to New Zealand from overseas (Australia, UK, US) are being forced to switch to alternate regimens as the medications they are taking are not available in New Zealand • People that are accessing Truvada as a preventative measure (PrEP) are direct importing the medication for personal use via the internet.
With this new injection of funds there is an opportunity for New Zealand to catch up with other countries such as Australia and provide world class health care to its citizens.
Atripla – approved 23 July 2009 – Funded Dec 2012.
Approved but not funded: Eviplera – 5 July 2012 (One pill daily), Stribild – 6 March 2014 (One pill daily), Triumeq – 18 Jun 2015 (One pill daily), Vitekta – 9 Oct 2014, Tybost – 28 Aug 2014