Concerns have been raised that the cost of a new once-a-day HIV pill could be priced out of the market, as it is submitted to European regulators.

ViiV Healthcare have presented the application for a tablet combining dolutegravir (DTG), abacavir (ABC) and lamivudine (3TC), likely to be known as Trii.

But despite recent successful tests, Andrew Crawford-Jones, a HIV nurse and beyondpositive columnist, believes the cost of DTG is so high that doctors are unlikely to prescribe it over existing antiretrovirals.

He said: “Trials have shown it is superior to current first line treatments which has caused a bit of a stir.

“All in all it would be a great drug but the actual chance of you getting it prescribed is very low because ViiV Healthcare have priced it really high.”

He added that he believed the cost to healthcare professionals would be ten times the price of gold per gram, which may mean the company will struggle:

“To gain a market share they will need to price this co-formulated product [Trii] similar to ATRIPLA or Eviplera which I doubt they will do.”

DTG is currently awaiting approval by the European Medicines Agency. ABC and 3TC are already available combined for use as an antiretroviral in the EU, branded as Kivexa.

Dr John Pottage, Chief Medical Officer for ViiV Healthcare says that putting the three drugs together in a single pill would be effective for both patients and medical professionals.

He said: “People living with HIV and their doctors seek to use appropriate treatment options for the individual, while also trying to minimise the number of pills required for effective and acceptable antiretroviral treatment.”

Andrew agrees that Trii has potential because it uses DTG: “The tolerability [of DTG] is super high and really no side effects of any great concern from trials.

“The reality will be though that it is hard to get access to because of price, although when the new NHS tariff comes next year we will have more of an idea.”

A similar regulatory submission was presented to the US Food and Drug Administration last week for use in the United States.


  1. Foolish to put the price so high when up to 10% of people will be unable to take the pill because of its abacavir content. Lamivudine is due to come out of patent in the relatively near future, so really dolutegravir is the only new drug on offer here.

  2. Very true – and to be honest we don’t really know what the price is going to be however dolutegravir on it’s own has been priced super high in America so the current speculation is it will be expensive here too. I can’t see them price matching it to atripla but maybe they will match it to stribild? If the single agent comes in cheaper than raltegravir then that would be good – especially as it is once a day. With the onset of generics it’s going to be interesting times ahead


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