Question
When will I be able to start dolutegravir in the UK?
26 September 2014. Related: All topics, Newly diagnosed, Starting treatment.
I am aware that the decision about the availability of dolutegravir is to be made in mid-October. Will it then be possible to start with dolutegravir, with either Kivexa or Truvada (ie 2 pills once a day)?
I was diagnosed earlier this month with a very recent infection and my CD4 count is 650.
However, I would prefer a single pill regimen. Will the single pill combination of dolutegravir plus Kivexa (Triumeq) be available shortly as well?
Thank you
Answer
Hi
Thanks for your question.
Predicting when a drug becomes available in the UK is difficult because of the NHS process. This delay is frustrating, given that dolutegravir was approved by the EU in January 2014.
The consultation exercise for guidelines on how dolutegravir will be prescribed is still ongoing. However, you are right that this finishes soon and that a decision should therefore be made by mid October.
Until this is finalised, access is limited to people with an urgent medical need and who have no alternative drugs. After the decision in October, dolutegravir is likely to be more widely available, but there still might be limitations on who can use it.
If you are interested in starting early treatment because you are only recently infected, it would be better to start now using existing treatment. You can always change treatment later as new drugs become available.
There are already many very effective combinations and most of these only involve taking one or two pills a day. To get the best impact from potential benefits or earlier treatment, it is better to start as earlier as you can, rather than delaying this. See this link for a related discussion:
https://i-base.info/guides/starting/early-diagnosis
It is unclear whether the single pill formulation of dolutegravir plus Kivexa will need to go through a similar NHS review. It might be much quicker given that the individual drugs are already approved. This will also depend on the price that the manufacturer decides to charge.
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