E-DRUG: MSF on FDCs
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Dear e-druggers,
It should be noted that fixed-dose combinations are *already* showing their
benefits in resource-poor settings.
MSF uses FDCs in most of its ARV projects, and has done so for more than a
year, with excellent results, in terms of both adherence and clinical
outcomes.
Presently MSF has approximately 11,000 patients in around 45 projects in 22
countries. Of these between 70-80% are on FDCs, mostly the d4T/3TC/NVP from
Ranbaxy and/or Cipla.
Nine MSF's 10 largest projects, treating over 6200 patients, use FDCs. Seven
of these projects began treating patients in 2001 and 2002. Collated results
in October 2003 showed that adherence was excellent, at 87.6% (9.9% died,
1.2% were lost to follow up, 0.8% were stopped due to poor compliance).
Clinical, immunological and where available virological results are
comparable to Western standards, even in severely ill patients.
FDCs have greatly assisted our efforts to rapidly increase the numbers on
ART. The safety, quality and efficacy of these FDCs has been validated by
the WHO pre-qualification system as well as by our own pharmacists, and
their bioequivalence with the originator formulations has been
demonstrated.
Their lower price is an additional, obvious advantage: with prices at least
half that of equivalent brand drugs, governments could treat 2-3 times more
patients with the same outlay, if they used generic triple FDCs instead of
the brand-name equivalents. This is why the Global Fund and UN Agencies are
so supportive of their use
For more, have a look at a briefing paper we've just prepared on the topic:
http://www.accessmed-msf.org/prod/publications.asp?scntid=16220041418372&con
tenttype=PARA&
Cheers, Sean