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2-in-1 Single Tablet Regimens for HIV Now Covered by ODB

By Zahid Somani, RPh

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As of January 31, 2020, both Dovato and Juluca are covered by ODB. This means that if you are on Trillium or other Ontario government insurance plan (including ODSP, Ontario Works, Seniors, etc) Dovato and Juluca will be paid for by these plans.

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Are you thinking of switching to a single-tablet regimen for HIV?

Single-tablet regimens simplify the medications you take to control HIV, by allowing you to take just 1 pill, once a day to suppress the virus in your body.

Today, single tablet regimens for HIV treatment are common. They are combination of 2 or 3 drugs in 1 pill. This type of combination treatment, called Antiretroviral Therapy or ART for short, has fewer side effects and is highly effective at suppressing the virus in the body.

What are single tablet treatments?

Single tablet treatments contain medications from different classes of drugs. You may have heard terms like protease inhibitors, integrase inhibitors, NRTIs (nucleoside reverse transcriptase inhibitors) and others. Over the past number of years, researchers have discovered that combining different classes of drugs to treat HIV resulted in lower rates of the virus becoming resistant to treatment, and had better results over the long term. Atripla and Triumeq are 3-in-one medications that contain three different drugs from a mix of these classes, and they are commonly prescribed today. Treating HIV with multiple drugs is called Antiretroviral Therapy or ART for short. ART is highly effective at suppressing the virus in the body.

So, what’s new in HIV treatment?

The biggest news in HIV treatment is ‘Dual Drug Therapy,’ that is, 2-in-one single tablet treatments. Researchers have been looking for ways to reduce the cost and side-effect burden of HIV therapies. By reducing the number of drugs from three to two in a single tablet, researchers found that they can maintain viral suppression and overall good health, with lower cost and fewer side-effects.

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Dovato is the latest single tablet regimen available for the treatment of HIV. As of January 31, 2020, Dovato is covered by the Ontario Drug Benefit program (ODB).

Dovato was approved by Health Canada in September 2019. It contains two medications in one pill: Dolutegravir (an integrase inhibitor) and 3TC (also known as lamivudine, an NRTI). Dovato is a small pill that is taken once a day with or without food. Clinical trials show that it is just as effective as other 3-in-1 medications currently on the market. Dovato has been approved for use by people who are newly diagnosed with HIV and just starting anti-retroviral therapy, or those with high viral loads. Trials are currently underway to assess the effectiveness of Dovato when switching from more complicated regimens. Initial results are promising.

Juluca is also a new 2-in-one that is approved for use in Canada, and it is covered by the Ontario Drug Benefit program (ODB).

Juluca contains Dolutegravir (an integrase inhibitor) and Rilpivirine (an NNRTI). Doctors will consider prescribing Juluca as maintenance therapy, that is, once the virus has remained suppressed or has been undetectable for some time. Research shows that patients who switched from more complicated regimens to a 2-in-one treatment like Juluca did fine, with the rates of success and side-effects about the same as 3-in-one treatments.

How much does Dovato cost in Ontario?

So, how much does it cost? 3-in-one treatments like Triumeq cost about $1600 per month. Dovato costs about $1100 per month, however, as of January 31, 2020, the cost will be covered by the Ontario Drug Benefits plan. If you are not on ODB, or other insurance plan, please come in to talk to us at The Village Pharmacy- we can help. We have Dovato in stock, and can help you get Dovato even if you don’t have insurance.

How much does Juluca cost in Ontario?

Juluca costs about $1200 per month, and as mentioned above, is now covered by ODB, and Trillium. Private health insurance plans will likely provide coverage for Juluca. If you need help navigating coverage for Juluca, please give us a call at The Village Pharmacy.