BURLINGTON, Mass.--(BUSINESS WIRE)--Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that the current dominance of Bristol-Myers Squibb/Gilead’s Atripla in the human immunodeficiency virus (HIV) drug market will be challenged over the next decade by two emerging fixed-dose combination products—Gilead’s Quad and Gilead/Janssen’s Complera (rilpivirine/emtricitabine/tenofovir). Quad, the first integrase inhibitor-based fixed-dose combination to enter the HIV drug market, is forecast to become the market leader by 2020 with more than $3 billion in sales in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan.
The findings from the Pharmacor topic entitled Human Immunodeficiency Virus reveal that concerns regarding the virological failure rate of rilpivirine (Janssen’s Edurant) will somewhat limit uptake of the rilpivirine/emtricitabine/tenofovir coformulation, Complera. However, Complera’s improved safety profile over Atripla will drive it to garner more than $2 billion in sales by 2020 and is expected to position Complera as the non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen of choice.
Sales of HIV antiretrovirals generated $13 billion in 2010 in the world’s major pharmaceutical markets and will increase to more than $16 billion in 2020. The uptake of key premium-priced emerging agents such as Complera, Quad and Gilead’s cobicistat will be the key driver of market growth. The findings also reveal that the two most recently launched new drug classes—the integrase inhibitors and the chemokine receptor 5 (CCR5) antagonists—have received mixed reviews from interviewed HIV specialists.
Merck’s Isentress, the first-in-class integrase inhibitor, has been praised for its low toxicity and high efficacy. However, physicians have also noted its comparatively low barrier to resistance, high cost and twice-daily dosing—weaknesses that a new integrase inhibitor could improve on. Despite these concerns, the overall perception of Isentress is positive and the agent has seen a healthy uptake in the market, with sales expected to reach $1.4 billion by 2017. Thereafter, sales of Isentress are expected to decline as a result of Quad and Shionogi/ViiV’s dolutegravir gaining market traction. Meanwhile, the sole CCR5 antagonist on the market, ViiV’s Selzentry, has not had as positive a reception by prescribers.
“While Selzentry is recognized as a highly effective and safe treatment option, the major obstacles to its use have been the required tropism assay and limited patient eligibility,” said Decision Resources Analyst LaTese Briggs, Ph.D. “The introduction of an improved trophile test would have a significant positive impact on the perceived value of the CCR5 antagonists as a class.”
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