Eviplera withdrawn from Russia as HIV procurement shifts to newer, cheaper therapies
Russia has cancelled the registration of Eviplera at Johnson & Johnson’s request after demand for the HIV therapy fell sharply. The drug remained the country’s most expensive HIV treatment despite a 30% procurement price reduction in 2025.
Registration cancelled after demand declined
Russia’s Health Ministry withdrew the registration certificate for Eviplera on July 15, completing the exit of a combination HIV treatment that had once ranked among the country’s largest antiretroviral purchases. The registration was cancelled at the request of its holder, the Russian subsidiary of Johnson & Johnson, the ministry told Kommersant. Eviplera combines rilpivirine, tenofovir and emtricitabine.
Johnson & Johnson said the decision reflected the availability of alternative treatment options and a substantial decline in demand. The company stressed that the withdrawal was unrelated to the drug’s quality or safety and said regulators, medical professionals and patient groups had been informed. Russia purchased no Eviplera under centralized state contracts in 2026, while the Health Ministry said that procurement in 2025 had covered 100% of identified demand.
Price cut failed to restore competitiveness
According to calculations by healthcare expert organization Zdravresurs cited by Kommersant, the Health Ministry and regional authorities purchased about 1,500 Eviplera courses for 384 million rubles in 2025. Spending was 9.2% lower than in 2024, and the drug represented less than 1% of total treatment courses in both years. At the beginning of 2025, prices in government contracts fell by 30% following negotiations with the manufacturer.
Even after that reduction, Eviplera remained Russia’s most expensive HIV therapy. Zdravresurs put the 2025 cost at 252,900 rubles per course, compared with 171,100 rubles for Biktarvy and 21,900 rubles for the cheapest second-line regimen containing atazanavir. Eviplera itself was used as a second-line therapy, prescribed when an initial regimen stopped working because of viral resistance or adverse effects.
The decline was pronounced compared with Eviplera’s earlier position. In 2021, it was among Russia’s three most-purchased antiretroviral medicines, attracting 5.51 billion rubles in budget spending, according to the Treatment Preparedness Coalition. Only dolutegravir received more, at 7.14 billion rubles. Kommersant reported that purchasing began to fall in 2022, when spending halved year on year to 1.9 billion rubles after Biktarvy and Genvoya entered Russia’s essential medicines list.
Alternatives take a larger role
The Russian market continues to offer both single-component and combination antiretroviral therapies. Zdravresurs identified Gilead Sciences’ Biktarvy and Genvoya, MSD’s Delstrigo and the domestically produced Elpida Combi as alternatives to Eviplera. Prices for Biktarvy and Genvoya also declined in early 2025, by 21.7% and 23.1%, respectively, but their reductions were smaller than Eviplera’s.
Eviplera’s protection in Russia runs until August 2027. A domestic analogue, Pharmasyntez’s Tenriltab, is registered, but has not yet entered circulation according to Roszdravnadzor. Pharmasyntez declined to discuss its launch prospects. RNC Pharma development director Nikolay Bespalov told Kommersant that willingness to make price concessions is decisive for many state-sector pharmaceutical decisions, while the continuing shift toward more modern HIV regimens also contributed to Eviplera’s withdrawal.