South Africa achieved a massive R2.2-billion cost reduction in the R5.9-billion tender awarded to three pharmaceutical companies on Thursday for single-dose antiretroviral (ARV) drugs for the government's HIV treatment campaign.
Making the announcement in Pretoria, Health Minister Aaron Motsoaledi said that the majority of South Africans on state-sponsored ARV treatment for HIV would, from April 2013, need only one tablet instead of the current three per day.
Motsoaledi said South Africa had managed to reduce the cost of the tender - for for a single dose of the triple combination of tenofovir, entricitabine and efavirenz - by 38%, a massive saving of R2.2 billion.
'Means we can treat more patients'
The price of the three-in-one combination is R89.37, which Motsoaledi described as now the world's lowest price for this product.
The tender was awarded to South African companies Aspen Pharmacare and Cipla Medpro along with US firm Mylan Pharmaceuticals.
"This new tender has moved from an original cost of R8.1-billion to R5.9-billion for two years," Motsoaledi said. "This savings means we can treat more patients with the same budget."
Motsoaledi said, from April, all pregnant women who were HIV positive would be given the single dose combination during pregnancy and breast feeding, regardless of their CD4 count.
At least 80% of patients on ARV treatment would also be able to switch to the single-dose combination, though Motsoaledi noted that those who couldn't switch for any reason could still take individual ARV drugs.
Benefits of the single-dose combination
Motsoaledi said the single-dose combination had major benefits for patients, and not only in terms of compliance with the daily routine; the combination meant fewer side-effects, and easier logistics and storage.
"The fixed dose combination ... is more effective than dual therapy and has fewer side-effects for the pregnant mother, in addition to its convenient dosage regimen."
The drugs will be available in all 3 000 registered health facilities across the country, said Motsoaledi, adding that there would be no more delays in supply, as experienced with the previous supplier.
"We have asked the suppliers to give us their commitment on this, and all three of them have done so."
Dr Francesca Conradie, clinical adviser for TB/HIV at Wits University's Clinical HIV Research Unit, said the new combination would not be harmful to pregant mothers in any way.
"Simplification of the tablets is so much easier for mothers, and it will lead to better results," Dr Conradie said.
UNAids country coordinator Dr Catherine Sozi commended South Africa for being able to access the effective drugs at a small price.
"The reduction in cost is way beyond what we've hoped for," Sozi said.