There are warnings a rise in the use of non-branded, cheaper HIV drugs may see more patients with treatment failure.

According to the journal Annals of Internal Medicine the US health care system could save almost $1billion by using generic medicines- however trial data shows they may not be as effective. 

Responding to reports about the use of branded and generic HIV treatments, Heather Leake Date, RPS spokesperson on HIV medicines said:"This new research from the US is interesting and addresses the topical question of how best to optimise treatment as more HIV medicines become available as generics. However it's important to note that this study does not conclude that branded medicines are better than generic medicines. Generic HIV medicines are expected to be as effective as their branded equivalents. What this research does say is that we should carefully consider the benefits of reducing the costs of HIV treatment through use of generics, with the possible increased risk of patients missing doses as they may be taking more tablets.

We can't ignore the cost savings from generic medicines and in the UK we will are constantly looking at how we can best use resources but crucially maintain the effectiveness of treatment. This means that when generic efavirenz becomes available (probably at the end of 2013) it is likely there will be a shift away from Atripla (tenofovir, emtricitabine, efavirenz) to Truvada (tenofovir, emtricitabine) with generic efavirenz. This means people will take 2 tablets once a day rather than one tablet once a day. The evidence shows us that this is unlikely to have an impact on how well people take their treatment.

However, we will always tailor the medicines we use to the patient's individual needs and the decisions about what medicines to use would be a shared one between the patient and the health professional."