B.C. was once a global leader in treatment for HIV/AIDS but is now falling behind in provision of one long-term drug, says AIDS Vancouver.
The group — formed 40 years ago as one of the first AIDS advocacy and research organizations in Canada — says B.C. is denying access to Cabenuva, an injectable HIV treatment that can last up two months before another shot is required.
“It’s been over three years since Health Canada approved the first long-acting HIV treatment, but B.C. is blocking access for people who want this treatment,” said AIDS Vancouver.
HIV is human immunodeficiency virus, the virus that causes acquired immunodeficiency syndrome, or AIDS. The World Health Organizations estimates 40.4 million people have died globally since the epidemic began.
In a statement, the B.C. Ministry of Health said the drug should only be used in specific circumstances. A ministry spokesperson said the drug has been reviewed by the BC Centre for Excellence in HIV/AIDS and is available through the centre in limited circumstances with approval on a case-by-case basis.
“Because of the particulars of the drug, this is recommended in very specific clinical circumstances, consistent with the product’s regulatory approval,” the ministry said. “All antiretroviral requests are reviewed for effectiveness and safety for the individual.”
Health Canada’s website said the drug was first marketed in September 2020 after approval that May.
In an online petition, AIDS Vancouver acknowledged the province currently provides long-acting HIV treatment, but only on a case-by-case basis.
Unlike other HIV medications, the group says B.C. requires additional approval processes and paperwork that aren’t consistently applied and are based on criteria that don’t align with Health Canada guidelines.
“This unnecessary process is hurting people and blocking vital care,” AIDS Vancouver said.
Beyond its health benefits, AIDS Vancouver said there are several reasons for providing the drug, including ensuring privacy.
“Some people need to be discrete about their HIV medications in order to keep themselves safe from violence based on their HIV status,” it said. "And, the long-lasting effect means people don’t have to worry about taking pills every day.”
In an information sheet, the centre said that, prior to submitting a request for Cabenuva usage, careful consideration should be made to ensure a patient understands and is able to adhere to the injection dosing schedule requirements.
“We have the drug approved, health care providers trained, the equipment and cold storage needed to deliver,” the group said. “What is missing in this picture? Patients. The government is blocking access to this life saving care,” wrote the group.
Access to drug requires application, specialist approval, says ministry
Cabenuva is an extended-release injectable drug designed to treat HIV-1 infections in people 12 and older, according to the ministry.
It said healthcare providers experienced in the management of HIV can request Cabenuva for eligible patients by making an application to the BC Centre for Excellence in HIV/AIDS, which reviews such applications on a case-by-case basis.
For a patient to receive approval, the ministry said applications are reviewed for completeness and eligibility is confirmed using both clinical and logistic considerations. The results are sent to the centre where a specialist makes a decision on providing the drug to the patient, according to the ministry.
“How long the process takes varies depending on completeness of application and confirmation of clinical eligibility and logistic support,” the ministry said.
Any licensed B.C. prescriber or doctor may submit a request for the drug.
Drug hailed as a 'paradigm shift' in HIV treatment
Produced by the Johnson & Johnson-owned Janssen Pharmaceutical Companies, Cabenuva offers patients a significant change of pace in their treatment of HIV. Instead of taking daily pills, patients on the drug receive six injections a year.
University of North Carolina Dr. David Alain Wohl, a paid Janssen consultant, said “The once-monthly injections of Cabenuva showed comparable efficacy to daily oral antiretroviral treatment in maintaining viral suppression”
The company says using the drug can lead to a drop in the amount of HIV in the blood to levels so low they are undetectable in a laboratory test.
“Continued advances like Cabenuva are truly a paradigm shift in treatment for those living with HIV,” it claimed.
AIDS Vancouver did not respond to a request for further comment.
