Geneva, 29 November 2022 – Doctors Without Borders/Médecins Sans Frontières (MSF) today called on pharmaceutical corporation ViiV to urgently take down barriers preventing access to the most effective form of HIV pre-exposure prophylaxis (PrEP), long-acting cabotegravir (CAB-LA), currently produced in only one manufacturing site, here in the UK.
CAB-LA is administered as an injection every two months and has proven itself more effective than the once-daily oral PrEP pills, but ViiV is not making the drug affordable or available in places where it is urgently needed.
Around 1.5 million people were newly infected with HIV in 2021, which is far from the global target of reducing new annual infections to 370,000 by 2025, and affordable access to CAB-LA could play a major role in reducing infections and saving more lives globally.
“The rollout of long-acting injectable cabotegravir would be hugely beneficial for reducing new HIV infections for people at risk and break the cycle of transmission particularly in places where HIV prevalence is high,” said Dr Mounia Amrani, Medical Team Leader with MSF Southern Africa. “Yet ViiV’s so-called ‘access price’ is still prohibitive and will likely hinder government treatment programmes from being able to roll out CAB-LA for use at the scale needed” concluded Amrani.
ViiV has not been transparent about its “access price”, but according to publicly available information, it’s between US$240-276 per person per year, 12 times higher than what the Clinton Health Access Initiative (CHAI) estimatesa generic price could be; less than $20 per year.
Today’s oral HIV PrEP pills are priced at $40 for one year.ViiV should publicly announce its “access price” and ensure that it is comparable to the current price of oral PrEP in low- and middle- income countries (LMICs) so that governments and treatment providers can accelerate rollout of this lifesaving intervention.
In December 2021, CAB-LA's registration was approved for prevention of HIV infections in the United States, and there are a small number of pending applications for use in other countries. Yet ViiV should do more to register CAB-LA globally as it remains unavailable in most countries, preventing millions of people from accessing this desperately needed drug.
This is particularly concerning, as ViiV will be the only supplier of CAB-LA until generic versions are developed, registered and commercially available, a process expected to take at least four to five years. Until generics are registered and available, ViiV should ensure sufficient supply of CAB-LA and should be transparent about its manufacturing capacity. And, in order to mitigate the risk of shortages and stockouts, ViiV should make sure a second manufacturing site can produce CAB-LA.
At present, ViiV donates CAB-LA in some low-and middle-income countries under its own program. However, MSF and other actors would like to start using CAB-LA for HIV PrEP in several pilot projects and urges ViiV to cease current restrictions and allow normal procurement, importation and use as per World Health Organization (WHO) recommendations.
Jessica Burry, HIV/HCV Pharmacist with MSF’s Access Campaign said, “ViiV should urgently prioritise increasing access to CAB-LA by reducing and publishing its price, ensuring sufficient supply until generics are available, and getting rid of unwieldy requirements for those seeking to use it. Governments should also act fast to approve CAB-LA in-country, include it in national HIV guidelines and accelerate its rollout to prevent HIV transmission”, finished Burry.