Government will be able to supply state patients with three antiretroviral drugs (triple therapy) for less than R100 a month.

This is according to prices set down in the government antiretroviral drug tender, which was finally issued this week, six months later than scheduled.

Local generic drug producer Aspen is the main beneficiary of the tender, while Indian generic producer Cipla will supply one of the drugs needed.

Brand name drugs from the large pharmaceutical companies, GlaxoSmithKline, Boehringer Ingleheim, Bristol Meyers Squibb, MerckSharpe&Dohme and   Abbott, are only included where there are no generic alternatives.

‘€œThese prices show that drug costs are no longer a major barrier to treatment,’€ said Andy Gray, senior pharmacy lecturer at the Nelson Mandela School of Medicine.

‘€œBut there are other costs involved, including expensive laboratory tests for CD4 counts and viral load and big staff costs.’€

Gray also expressed concern for price increases during the tender period.

Boehringer Ingleheim is the only company to guarantee that it will not increase the price of the drug it is supplying, nevirapine, over the tender period. Aspen’€™s prices only rise by 6% after 18 months.

Abbott is providing its drug, lopinavir, to the state at the same price as in the private sector. However, it has pegged its prices for Kaletra and Norvir at $500 per patient per year for the duration of the tender, which ends in August 2007. It says increases will only come about in relation to currency fluctuation.

GlaxoSmithKline’€™s price for 3TC is almost a third of the private sector cost, while AZT is almost the private sector half price.

First line treatment of the drugs d4T (stavudine), 3TC (Lamivudine) and nevirapine for an adult weighing 70kg will be about R97.26 a month.

Where efavirenz is substituted for nevirapine, the drug the price rises to R269.96.

Second line treatment of AZT, ddI and lopinavir will cost R534.98. This treatment will be resorted to if patients fail to respond to the first regimen, perhaps because they have been on antiretroviral drugs in the past and developed resistance, or because of side-effects.

Three different classes of antiretroviral drugs, called triple therapy, are needed because the virus mutates rapidly, and can develop resistance to a single drug with relative ease. Each of the three drugs are from a different class and interacts with the virus at a different stage of its lifecycle.

E-mail Kerry Cullinan