7 Oct

New addition to provincial drug plan NIHB program treats HIV

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A medication recently added to the list of drugs covered by the province may soon be the HIV treatment of choice, says one Regina doctor.“I think over the next few months as people start to gain some familiarity with it, I think it will become probably one of the top options available,” said Dr. Alexander Wong of Biktarvy, a once-daily single-tablet treatment.Effective Aug. 1, the medication is now covered under the Saskatchewan Drug Plan and the Non-Insured Health Benefits (NIHB) program, making it more widely accessible to doctors across the province. “It’s a good medication,” said Wong, who is an assistant professor of infectious diseases with the University of Saskatchewan’s College of Medicine and also works at the Regina General Hospital.The medication is the second-smallest single-tablet treatment publicly available, at about 60 per cent the size of a typical multi-vitamin and is also only required once a day, increasing the chances of patient compliance, said Wong.Story continues belowThis advertisement has not loaded yet,but your article continues below.“For many of the patients that we work with in the province, there are a lot of other concurrent challenges — housing, food security, mental illness, addictions and so forth —which make adherence to medications not easy,” he said.According to Wong, there are very few downsides to Biktarvy, which has become an effective option for nearly all patients, except those on tuberculosis medications because of drug interactions. Additionally, he said doctors are also refraining from prescribing it to pregnant women because there isn’t enough research into the impacts on those individuals yet.Drug trials have deemed the medication safe in the short and medium term (with the above exceptions), said Wong, but clinicians will need to carefully track long-term impacts.“Our experience with some of the components of the drug is still a bit limited… so we need to be vigilant to ensure there are no long-term side effects and toxicity issues,” he said.The drug was previously only available in a limited fashion, through a compassionate access program where industry provides a limited number of prescriptions until the drug gets public funding.The program allows clinicians to get some degree of experience with the drug ahead of time, but not all doctors know about the program and some don’t use it perhaps because they don’t want to “jump through all the hoops,” said Wong.“It’s universally available now for all patients with no restrictions, no limitations whatsoever and there’s no paperwork process or other such things that may discourage clinicians from using it,” he said.Biktarvy is not the only, but is the newest single-tablet regimen option to be listed on the provincial drug plan. “The decision to list Biktarvy was made based on the Canadian Drug Expert Committee recommendation, advice from the Drug Advisory Committee of Saskatchewan (DACS) as well as successful negotiation between the pan-Canadian Pharmaceutical Alliance (pCPA) and the manufacturer,” said a written statement from the Ministry of Health.But access to medication is only one piece of the puzzle.Wong says universal testing is essential in Saskatchewan’s battle against notoriously high rates of HIV compared to the rest of Canada.“At the end of the day the message is that there’s ongoing vigilance that’s required,” he said. “We’re trying to identify and sort out what some of the changing dynamics are and the reasons for why we’re continuing to see such high numbers.”A lack of resources in certain parts of the province is a challenge, as is trying to address other aspects of patient health like mental health and addictions and fight against stigma, explained Wong.But there are success stories, he added.In Regina, clinicians have worked closely with the city’s emergency and acute care departments to do more HIV testing.“As a result that’s allowed us I think to identify a lot more patients that are coming transiently through the hospital,” said Wong, who also pointed to Saskatoon’s commitment to safe consumption site as examples of good work that needs to be expanded on throughout the [email protected]

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