MOH adds HIV medications to list of subsidised drugs in S'pore

The subsidy will keep the cost of HIV medication manageable.

Joshua Lee | September 02, 2020, 12:14 PM

For the first time in Singapore's history, HIV medications have been added to the Ministry of Health's list of subsidised drugs.

16 HIV medications, known as Anti-Retroviral Therapy (ART), including, but are not limited to, Abacavir & Lamivudine (commonly sold under the brand name Kivexa) and Abacavir, Dolutegravir & Lamivudine (commonly sold under the brand name Triumeq) have been added to the list.

Both Kivexa and Triumeq are covered on the Standard Drug List, which is the list of subsidised drugs in Singapore. Triumeq, which previously cost around S$580 would now cost S$290 at NUH.

Depending on their means testing status, patients requiring HIV medication can now receive subsidies of 50 per cent or 75 per cent.

According to MOH, the ministry regularly reviews the subsidised standard and non-standard drugs to ensure that they remain relevant to changes in local population needs, medical practice and evidence on clinical and cost effectiveness.

"The inclusion of 16 antiretroviral drugs on September 1, 2020 is part of this regular review," said MOH.

Here are the 16 HIV antiretroviral drugs:

Lamivudine tablet (150 mg) [3TC] SDL
Zidovudine capsule (100 mg) [ZDV or AZT] SDL
Efavirenz tablets (200 mg, 600 mg) [EFZ] SDL
Etravirine tablet (200 mg) [ETR] SDL
Nevirapine tablets (200 mg immediate release tablet, 400 mg extended release tablet) [NVP] SDL
Rilpivirine tablet (25 mg) [RPV] SDL
Atazanavir capsules (200 mg, 300 mg) [ATV] SDL
Darunavir tablets (600 mg, 800 mg) [DRV] SDL
Lopinavir 200 mg/ Ritonavir 50 mg tablet and

Lopinavir 80 mg/mL & Ritonavir 20 mg/mL oral solution (160mL) [LPV/r]

SDL
Ritonavir tablet (100 mg) [RTV] SDL
Raltegravir film-coated tablet (400 mg, 600mg) [RAL] MAF*
Dolutegravir tablet (50 mg) [DTG] SDL
Abacavir 600 mg/ lamivudine 300 mg tablet [ABC/3TC] SDL
Abacavir 600 mg/ dolutegravir 50 mg/ lamivudine 300 mg tablet [ABC/DTG/3TC] SDL
Emtricitabine 200 mg/ tenofovir disoproxil fumarate 300 mg tablet (FTC/TDF) MAF*
Tenofovir disoproxil fumarate tablet (300mg) [TDF] SDL

Reactions to subsidy

"I am grateful for this move by MOH to include HIV medications in the subsidised drugs list. Just like how HIV is a manageable condition, the price for medication should be as manageable. Now I can save up more for my future!", said 24-year-old Calvin, an HIV advocate who also lives with HIV.

HIV non-governmental organisation Action for AIDS, Singapore (AFA) said that it was "particularly heartened" by this move:

"We have long championed the need for ARTs to be subsidised and made affordable for all Persons Living with HIV (PLHIV). International and local experience have shown that ARTs are the most important clinical intervention for improving longevity and preventing opportunistic infections, which in turn leads to PLHIVs leading full and productive lives."

Reduce viral load

People living with HIV can reduce their viral load to undetectable levels if they take their medication regularly and have regular medical follow-up.

Research has also shown that having undetectable levels of viral load negates the possibility of virus transmission.

Roy Chan, President of AFA added that making ART affordable and accessible will improve the prognosis of people living with HIV and will also lead to better HIV prevention and control in the country.

Here is MOH's full statement about the inclusion of HIV drugs under the Standard Drug List (SDL) and Medication Assistance Fund (MAF):

"The Ministry of Health (MOH) provides subsidies for drugs that are clinically and cost-effective to improve the affordability of medications for patients. These drugs are placed under the Standard Drug List (SDL) and Medication Assistance Fund (MAF). MOH regularly reviews the subsidised standard and non-standard drugs to ensure that they remain relevant to changes in local population needs, medical practice and evidence on clinical and cost effectiveness. The inclusion of 16 antiretroviral drugs on 1 September 2020 is part of this regular review.

Previously, persons living with HIV may have received discretionary assistance from MAF on a case-by-case basis for the cost of their HIV treatments. All subsidised patients will now receive subsidies for drugs that have been added to the SDL of 50 per cent or 75 per cent, depending on patient’s means-test status."

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