Generic antiretrovirals and HIV care in the United States

摘要

In his recent editorial, Sherer (1) argues that generic antiretroviral therapies (ARTs) may result in decreased efficacy for persons living with HIV in the United States and calls for large-scale clinical trials comparing branded with generic ARTs. This editorial dangerously conflates the efficacy of generic medicines themselves with the effects of patent barriers that obstruct production of ideal generic regimens. The author's comments endanger the considerable benefits of generics and risk destroying patient trust in the concept of these agents. For example, because of patent barriers, individual components of the fixed-dose combination, branded medicine Atripla (Gilead Sciences and Bristol-Myers Squibb, Newark, New Jersey) cannot be combined into a single pill. Although there is evidence that single-pill combination HIV drugs lead to better treatment outcomes, this is a problem not with the generics themselves but with the inability to combine quality generic medicines into a single pill (2,3).