The New Zealand AIDS Foundation (NZAF) has welcomed the announcement that PHARMAC will subsidise ISENTRESS (raltegravir) from 1 October 2009.

However, despite clinical advice from both the Pharmacology and Therapeutic Advisory Committee (PTAC) and the Anti-Infective Subcommittee, PHARMAC will not fund Darunavir, a medication that increases the efficacy of ISENTRESS when the two are used together.

ISENTRESS, developed by Merck Sharp and Dohme, is the first in a new class of medications called integrase inhibitors and is suitable for people living with HIV who have developed resistance to their existing medications. "The availability of ISENTRESS is timely" says Eamonn Smythe, NZAF Director Positive Health Services. "Over the next few years increasing numbers of patients will require this new class of medication."

"PHARMAC should be applauded for their decision to fund ISENTRESS. However research has shown that ISENTRESS and Darunavir when used in combination with each other are extremely effective in the ongoing management of HIV," says Smythe.

"People living with HIV can, and do, develop resistance to HIV treatments. This is one of the greatest challenges in effective HIV management. Without access to new medications there are limited treatment options available to people who have developed drug resistance" says Smythe.

During the consultation process regarding the funding of ISENTRESS, the NZAF has asked PHARMAC for the rationale behind the decision not to fund Duranavir at the same time. As yet, the NZAF has not received a response.

Darunavir is a protease inhibitor developed by Janssen-Cilag. Both ISENTRESS and Darunavir were approved by Medsafe in 2008. In New Zealand, Janssen-Cilag provides free Darunavir to thirty people via a compassionate supply programme. In Australia, Darunavir has been funded for nearly two years.