SINGAPORE - Since 35-year-old Avin Tan was diagnosed with the human immunodeficiency virus (HIV) 12 years ago, he has travelled to places like Bangkok or asked friends to obtain more cheaply two drugs that he needs to take every day.
He also dropped the idea of switching to a newer drug with fewer side effects, as it costs more than he can afford.
So it was welcome news that the Ministry of Health has added 16 antiretroviral drugs used for the treatment of HIV to its list of subsidised drugs as of Sept 1, making them much more affordable for thousands of Singaporeans like Mr Tan.
Before this, it would cost him more than $500 a month to buy the two drugs he needs daily, Truvada and Edurant. Buying the same medication overseas in places like Bangkok would lower the cost to around $150 a month, and buying the generic version of the drug - which may not have a reliable supply chain - would cost around $55 a month.
The drugs have also been added to the Medication Assistance Fund here, which allows patients who cannot afford these drugs to draw from it to help pay for them.
All subsidised patients who purchase any of these 16 drugs will now receive 50 per cent or 75 per cent worth of subsidies, depending on patient's means-test status, the MOH said.
Previously, those living with HIV could receive help from the Medication Assistance Fund on a case-by-case basis.
The MOH told The Straits Times that it regularly reviews the subsidised standard and non-standard drugs to ensure that they remain relevant to changes in local population needs, medical practice and evidence on clinical and cost effectiveness.
"The inclusion of 16 antiretroviral drugs on 1 September 2020 is part of this regular review," it said.
Groups that work with HIV patients have long asked for antiretroviral drugs to be subsidised.
With their inclusion at last, Mr Tan, who is advocacy and partnerships manager at the non-profit organisation Action for Aids (AFA), will be consulting his doctor soon about switching to the newer medication.
Long-term use of HIV drugs could result in the premature onset of other diseases, such as hypertension, liver and kidney problems as well as osteoporosis.
Inclusion of these drugs also assures their safety, Mr Tan said.
"By making it possible for the drugs to be bought from hospitals, it allows for quality control and removes a lot of guesswork when we buy the drugs from other sources."
It will also aid in reducing the stigma and discrimination faced by those who are HIV positive, he added.
"It lowers the barriers for people to seek treatment, and allows HIV to be viewed just like any other illness."
Ms Sumita Banerjee, the executive director of AFA, lauded the move, saying that it will help to normalise HIV.
"Subsidies also allow people to adhere to treatment. This improves treatment outcomes and quality of life of people living with HIV. A person who is on treatment and has acquired viral load suppression cannot transmit HIV and so it is also important for HIV prevention," she said.
In a Facebook post last Wednesday (Sept 2), Dr Wong Chen Seong, deputy director of the national HIV programme at the National Centre for Infectious Diseases, said that the significance of this move could not be overstated.
"The dream of ending HIV in our lifetimes is one step closer to fruition. Access to effective HIV treatment is the sine qua non (it is essential) of getting people living with HIV to an undetectable viral load, which not only forms the foundation for personal health and well-being, but also prevents onward transmission," he wrote.
According to the MOH, a total number of 8,618 Singapore residents had been infected with HIV as of end-2019, of whom 2,097 had died.