Only One Third of People Living with HIV in Russia Received ARV Therapy in 2018

According to the report the estimated number of one year’s ARV therapy courses in 2018 was 383 514, which covers only a little over 50% of all registered Russian HIV positive people, that is at best just a third of all people living with HIV in the country.

The Coalition experts emphasize that at the same time 68.7% of the budget was spent on purchasing the following five ARV drugs: first of all, lopinavir/ritonavir, which had cost 5.26 billion Rubles or 22.01% of the total procurement amount, next in amount was raltegravir (2.87 billons and 12.02%, accordingly), etravirine (2.1 billions, 8.84%), atazanavir (1.9 billions, 8.24%) and emtricitabine/tenofovir/rilpivirine (Eviplera) (2.69 billion Rubles and 11.24%).

However, this is understandable. Generally these drugs belong to second-line and third-line antiretroviral regimens and though they are used less frequently, their cost is substantially higher. Eviplera is a combination drug and that is why it is quite expensive, too.

First-line drugs, or NRTIs, still remain leaders among other drugs in the number of one year’s treatment courses. They are prescribed to a majority of HIV positive patients if they have no resistance to these drugs and no contraindications.

For example the amount of tenofovir that was purchased for a little over 715 million Rubles (about 3% of the total procurement amount) is enough to provide therapy to more than 214 thousand people, while lopinavir/ritonavir (22% of the total procurement amount) – just for 92 thousand patients.

Meanwhile reducing the number of pills taken by a patient daily (which is achieved by using combination drugs) remains the main strategy all over the developed world, a reverse trend is evident in Russia.

As it is pointed out in the report, the proportion of single entity drugs in Russia’s procurement pattern increased significantly in 2018: from 75% in 2017 to 81.5% in 2018. But the proportion of “2 in 1” drugs decreased. In 2016 the proportion of “2 in 1” drugs was 38%, in 2017 – 24% and in 2018 – 16%.

Despite the fact that in comparison with the previous year purchases of Eviplera increased remarkably in 2018, the number of people who was able to receive the medicine remained insignificant – 8 346 patients. Altogether, just 2% of people living with HIV in Russia received a “single tablet regimen” in 2018.

According to the Coalition, the total ARV drugs procurement amount in 2018 was 23.92 billion Rubles, where 20.55 billion Rubles was spent by the Ministry of Health on centralized procurement and 3.21 billion Rubles was spent by the regions. In addition to that 154.47 million Rubles was spent on purchases of ARVT by specialized federal institutions.

Notably, the total HIV drugs procurement amount of the Russian Ministry of Health dropped by 769 million Rubles as compared with 2017. In 2018 minimum cost of the first-line treatment was 7 161 Rubles for one patient per year, the second-line treatment – 60 564 Rubles for one patient per year.