Jennifer Cohn, MD, MPH
Potential Conflicts of Interest: None disclosed.
Cohn J.; Generic Antiretrovirals and HIV Care in the United States. Ann Intern Med. 2013;158:777. doi: 10.7326/0003-4819-158-10-201305210-00017
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Published: Ann Intern Med. 2013;158(10):777.
TO THE EDITOR:
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).
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