What do frontline clinicians really think about current HIV treatment pathways and what are the most pressing unmet needs that industry can respond to?
What’s driving long term growth in HIV?
The market for HIV therapies has been growing fast–a 5 year CAGR (2007-2012) of 12.0%–but sustaining growth will be a challenge. The HIV sector is mature with many tried and tested treatment options, so what has underpinned growth to date and how can companies drive market expansion in the future?
The patient population is key
Current HIV therapies are effective in suppressing HIV and are successfully increasing patients’ life expectancy. However, they are not curative and must be taken for the lifetime of the patient. This means the market for HIV therapies will be sustained from the long-term maintenance of the current patient base whose numbers will swell as new cases are diagnosed.
Good times, bad times?
Valued at US billion in 2012, and with a 5-year CAGR (2007-2012) of 12.0 percent, the HIV sector is dominated by seven blockbuster drugs: Gilead’s Atripla and Truvada; Bristol Myers-Squibb’s Reyataz; Merck & Co.’s Isentress; Janssen Therapeutics’ Prezista; ViiV Healthcare’s Epzicom/Kivexa; and AbbVie’s Kaletra. With few payer restrictions on prescribing HIV therapies, no prospect of a cure or vaccine in the near future and limited uptake of generics to date, the sector is forecast to maintain stable returns until the end of the decade. However, driving high growth will be a challenge, and new products must show significant clinical and patient benefits if they are to succeed in a market already provided with established therapy options.
Game changers in the pipeline?
Medical adherence, improved efficacy and reducing toxicity are major challenges and there are a number of promising candidates in late trials–but how will they fare? Will ViiV Healthcare price Trii, its first single-tablet complete regimen, competitively? Tobira Therapeutics cenicriviroc has novel anti-inflammatory effects, but what are the regulatory hurdles it will have to overcome? And Gilead’s tenofovir alafenamide could address safety concerns associated with tenofovir; can it limit competition from generic alternatives?
Meeting the challenge of unmet need
Many of the challenges faced by clinicians are not related to efficacy, but include poor adherence to treatment, often exacerbated by societal and mental health issues, the stigma associated with diagnostic testing and low levels of early diagnosis. There are, however, opportunities for industry to improve patient outcomes. For example:
A complete ongoing analysis of current trends, forecasts and landscape modifiers
Harnessing the real world insights from leading US/European KOLs and research analysts, this study critically examines the HIV sector to expose the real potential. If you need instant access to an accurate, unbiased, qualitative review of the latest treatment trends along with a five-year quantitative HIV market forecast and insights as to the how HIV treatment will develop, look no further than FirstWord’s Therapy Trends: HIV. This insightful FirstWord research is provided in two comprehensive modules:
KOL Insight Report
Interactive Analytics File
Therapy Trends KOL Insight: HIV analyses the current and predicted key issues, current products and late-stage pipeline products. The report gives you qualitative, inside information from exclusive and detailed FirstWord interviews with 12 of the foremost key opinion leaders (KOLs) active in HIV treatment clinics in the US and Europe through the following:
Key Report Features and Benefits
All current therapeutic approaches covered
Expert Opinion for Real World Insights
The data and analysis in the report is enriched through the specific insights and opinions of leading clinicians working in HIV in the US and Europe. Their views on specific drugs and treatment pathways provide a unique front line perspective from those working in a clinical setting. The results of these detailed and extensive interviews are incorporated throughout the text so they can be read in the context of the issue or product being discussed.
Key Quotes from the Report
“We know that patients who are on therapy do better if they are taking one pill a day, as a combination pill, there is no question about that. We need the best possible fixed dose single combination pill.”
“Every patient who takes the drugs will be able to suppress the virus, so the question is not the potency of the combination, the question is the toxicity in the long-term. What about the kidneys? I mean everybody is taking tenofovir. We see the renal problems after years. We have an aging (HIV) population and we have to be prepared for the long run and I don't think we really are.”
“There are a lot of expectations with Trii. I cannot think of another drug where the expectations were as high. Trii could be a good option for many different patients, and you don’t have to worry about the renal issues. It's highly potent, very well tolerated, it doesn't have a signature toxicity. I see a bright future for Trii.”
“Current NNRTIs have a low barrier for resistance and a significant amount of patients are going to fail eventually with K103N [mutation]. Having an NNRTI that is able to overcome mutations is important.”
“My personal view is that it will have a very small impact. We know PrEP with Truvada works. The major problem is cost. You need to give the medicines to plenty of uninfected subjects to prevent a few cases of HIV.”
Use this detailed report and powerful interactive Excel spread sheet to compare and contrast companies and products now and in the future. Therapy Trends Consensus Outlook: HIV includes the following comprehensive resources:
Use Consensus Outlook to:
Content Highlights and Products Covered:
KOL, Analysts, Products and Companies
At a glance listings of those who contributed and the rich and varied sources used to produce this major analysis of the HIV market and its prospects.
Key Opinion Leaders
Products & Companies Covered
This report is continually updated in response to market developments stay in touch with the latest developments and thinking and maximise the value of this report
The world of pharma is ever changing and executives must always be up-to-date with the latest developments that could affect their own products, position and research. That is why FirstWord’s guarantee to keep Therapy Trends updated offers real commercial advantage. Consider the benefits:
Whatever happens in the market you’ll always be able to assess the impact with FirstWord Therapy Trends
Unrivalled Sources Ensure Complete Coverage
Our unique disease selection matrix pinpoints those disease sectors of the highest commercial potential, and draws information from multiple novel and expert sources, including:
Table of Contents
for HIV -- KOL Insight and Consensus Outlook Modules
Contents Consensus Outlook
2.FirstWord Analysis Highlights
5.Key HIV Developers
6.HIV Class Dynamics
7.Single-tablet complete regimens
7.1.Atripla (tenofovir/emtricitabine/efavirenz; Gilead/Bristol-Myers Squibb) forecast
7.2.Complera/Eviplera (tenofovir/emtricitabine/rilpivirine; Gilead) forecast
7.3.Stribild (tenofovir/emtricitabine/elvitegravir/cobicistat; Gilead) forecast
7.4.Tenofovir alafenamide fumarate (TAF)/emtricitabine/cobicistat/elvitegravir; Gilead forecast
7.5.Trii (dolutegravir/abacavir/lamivudine; ViiV Healthcare) forecast
8.Nucleoside reverse transcriptase inhibitors
8.1.Truvada (tenofovir/emtricitabine; Gilead) forecast
8.2.Epzicom/Kivexa (abacavir/lamivudine; ViiV Healthcare) forecast
8.3.Viread (tenofovir; Gilead) forecast
9.1.Prezista (darunavir; Janssen Therapeutics) forecast
9.2.Reyataz (atazanavir; Bristol-Myers Squibb) forecast
9.3.Kaletra (lopinavir/ritonavir; AbbVie) forecast
9.4.Norvir (ritonavir; AbbVie) forecast
10.Integrase strand transfer inhibitors
10.1.Isentress (raltegravir; Merck & Co.) forecast
10.2.Tivicay (dolutegravir; ViiV Healthcare) forecast
11.Non-nucleoside reverse transcriptase inhibitors
11.1.Intelence (etravirine; Janssen Therapeutics) forecast
11.2.Sustiva/Stocrin (efavirenz; Bristol-Myers Squibb/Merck & Co.) forecast
12.1.Selzentry/Celsentri (maraviroc; ViiV Healthcare) forecast
Contents KOL Insight
4.Current HIV market
4.2.HIV treatment landscape
4.2.1.HIV market definition
4.2.2.Current market overview by class
4.2.3.Current market overview by brand
4.3Reimbursement/formulary coverage of HIV drugs
5.Current marketed therapies
5.1.NRTI “backbone” drugs
5.1.1.Truvada (tenofovir/emtricitabine); Gilead
5.1.2.Epzicom/Kivexa (abacavir/lamivudine); ViiV Healthcare
5.2.1.Atripla (tenofovir/emtricitabine/efavirenz); Gilead
5.2.2.Complera/Eviplera (tenofovir/emtricitabine/rilpivirine); Gilead
5.3.Protease inhibitor-based regimens
5.3.1.Reyataz (atazanavir); Bristol-Myers Squibb
5.3.2.Prezista (darunavir); Janssen Therapeutics
5.3.3.Kaletra (lopinavir/ritonavir); AbbVie
5.4.Integrase inhibitor-based regimens
5.4.1.Isentress (raltegravir); Merck & Co.
5.4.2.Stribild (tenofovir/emtricitabine/elvitegravir/cobicistat); Gilead
5.4.3.Tivicay (dolutegravir); ViiV Healthcare
5.5.1.Selzentry/Celsentri (maraviroc); ViiV Healthcare
6.Pipeline HIV therapies
6.1.Integrase inhibitor-based regimens
6.1.1.Tenofovir alafenamide/emtricitabine/cobicistat/elvitegravir; Gilead
6.1.2.Trii (dolutegravir/abacavir/lamivudine); ViiV Healthcare
6.1.3.GSK1265744; ViiV Healthcare
6.2.Protease inhibitor-based regimens
6.2.1.Tenofovir alafenamide/emtricitabine/cobicistat/darunavir; Gilead
6.3.1.Doravirine; Merck & Co.
6.4.1.Cenicriviroc; Tobira Therapeutics
6.5.2.Unmet need one: Developing an HIV cure
6.5.3.Unmet need two: Improve patient drug adherence
6.5.4.Unmet need three: Identify interventions to reduce HIV infections
6.5.5.Unmet need four: Reducing long term toxicities of ART
6.5.6.Unmet need five: Improve HIV diagnosis
Current HIV treatment algorithm
6.6.HIV treatment guidelines
6.6.1.Cost of ART drugs
6.7.Future treatment algorithm
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