Dr Michael Brady (Terrence Higgins Trust) and Professor Chloe Orkin (British HIV Association) set out the joint position on the use of generic HIV medication.
Terrence Higgins Trust and the British HIV Association (BHIVA) support the use of generic antiretroviral therapy for people living with HIV, where there are no concerns around clinical outcomes or adherence.
We believe that people living with HIV should be at the heart of decisions made about their care. Therefore decisions around switching to generic HIV medication should be based on a full discussion between a person living with HIV and their HIV clinician.
HIV treatment is extremely effective. It enables people living with HIV to enjoy long and healthy lives and prevents onward transmission of the virus once someone has an undetectable viral load. HIV treatment and care in the UK is excellent – time and again it is held up as world leading. The use of generic HIV treatment will not change this. It is understandable that people living with HIV might be cautious if a change to their treatment is suggested during consultations with their HIV clinician, but generic medications are nothing to be afraid of.
The NHS uses generic drugs wherever it can in order to manage the cost of treating people for a variety of conditions. Generic drugs are also popular in pharmacies and supermarket – their own-brand paracetamol and ibuprofen are generic painkillers, for example.
Generics work as well as branded treatment – there is no difference in their quality or effectiveness. All treatments – whether branded or generic – go through rigorous testing before they are allowed to be supplied by NHS clinicians. Generic drugs will have a different name, different packaging and the pills are often a slightly different shape or colour, but the active ingredients in the tablet work in exactly the same way as branded drugs.
You should always check with your clinician or pharmacist if you have any concerns about taking generic drugs.
If you have been taking a once-a-day combination pill then changes to generic treatment may result in those drugs being prescribed in their separate components, meaning the number of pills you take may increase. When this is the case your HIV clinician or pharmacist should explain this to you.
Branded drugs and their generic drug preparations are the same so you should not experience any side effects from switching. If you do feel differently after starting generic treatment and this does not subside quickly, you should contact your HIV clinician or pharmacist. If you have concerns, for example if you struggle to swallow tablets and your pill burden (the amount of pills you have to take for your treatment) increases, then you should have a conversation with your HIV clinician. It is important that any switch of medication works for you and does not impact on your adherence and therefore your health and wellbeing.
We support the use of generic HIV treatment because it is of the same high quality as branded HIV treatment. Generic drugs also cost a fraction of the cost of branded drugs.
The cost of providing HIV treatment is considerable, and is increasing. Effective HIV therapy means that people can expect many decades of HIV treatment, which means a rising drug bill for the NHS. BHIVA treatment guidelines recognise the importance of the effectiveness of antiretroviral therapy. We also recognise that the NHS needs to take cost into account when prescribing the drugs for those who need them.
By making significant cost savings on treatment by using generic drugs, the NHS should be able to continue to provide other services that are important to people living with HIV.
Terrence Higgins Trust and BHIVA believe the most important factor in choosing treatment is still which drug will work best for the individual. If your clinician talks to you about generic treatment make sure you ask them any questions which are on your mind and let them know about any of your concerns.
If you have any questions about your prescribed HIV treatment you should talk to your HIV clinic team.
If you believe you are being treated unfairly regarding any aspect of your HIV treatment or if you were not made aware of changes to generic treatment prior to them being dispensed to you please contact THT Direct.