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Stakeholder Opinions: HIV/HCV Co-infection - Whose Niche?

Published by: Datamonitor

Published: Jul. 29, 2003 - 78 Pages


Table of Contents


TABLE OF CONTENTS

CHAPTER 1 EXECUTIVE SUMMARY 3

Scope of the analysis 3

Datamonitor insight into the HIV, HCV and co-infection markets 4

HCV is the most prevalent chronic infection within the HIV cohort, infecting over 30% of HIV positive individuals. However, the HIV/HCV co-infected population is primarily comprised of difficult-to-treat patient groups, such as intravenous drug users (IDUs). Companies wishing to enter this market need to balance investment in patient targeting campaigns against a potential increase in product uptake, which may be limited in scope 4

HIV/HCV patient potential is limited by poor compliance and low prevalence rates, limiting the incentive for novel product development. However, penetration of the co-infected market will enable companies to leverage their products into the wider HIV or HCV mono-infected populations 6

Treatment of HIV/HCV co-infected patients is complicated by drug-drug interactions and the hepatotoxic side effects of certain HIV products. The design and development of a treatment package with proven efficacy in the co-infected population would provide physicians with a convenient treatment strategy. In addition, it would facilitate collaboration between HIV and HCV companies, to the benefit of both 6

Summary 8

Key metrics 9

CHAPTER 2 PATIENT POTENTIAL 15

Introduction 15

Epidemiology 16

HIV prevalence 16

Disease progression 16

HCV prevalence 19

Disease progression 19

HIV/HCV co-infection 21

High-risk populations 22

Impact of HIV on HCV progression 24

Impact of HCV on HIV progression 24

Summary 24

CHAPTER 3 TREATMENT OVERVIEW 26

Current treatment options 26

HIV 26

Nucleoside reverse transcriptase inhibitors (NRTIs) 27

Non-nucleoside reverse transcriptase inhibitors (NNRTI) 29

Protease inhibitors (PIs) 30

Entry (fusion) inhibitors (EIs) 31

Key treatment strategies 32

HCV 33

Key treatment strategies 34

HIV/HCV co-infected patients 35

Current treatment strategies 36

Unmet needs in the HCV/HIV co-infection market 38

Poor compliance rates 39

Drug-drug interactions 40

Inefficacy of HCV therapy in co-infected patients 40

Diagnosis rates 41

CHAPTER 4 HIV/HCV MARKET PENETRATION STRATEGIES 42

Key companies 42

HIV 42

HCV 45

Expansion into HCV 46

Clinical trials 47

Case study: Fuzeon 47

Case study: Viread and Emtriva 48

Drugs with dual activity 49

Case study: Epivir and Hepsera 49

Can a cross-activity strategy be adopted for HIV/HCV treatment? 50

Entry into the HCV market 50

Case study: BI 51

Opportunities for company collaboration 55

Expansion into HIV 55

Entry into the HIV market 55

Case study: Roche 57

Summary 59

APPENDIX A 60

Contributing experts 60

List of tables 60

List of figures 61

Bibliography 62

Epidemiology 62

Clinical trial data 65

General 67

Websites 69

Company websites 70

Appendix B 72

About Datamonitor 72

About Datamonitor Healthcare 72

Datamonitor Healthcare’s research and analysis methodologies 73

Datamonitor Healthcare’s therapy area capabilities 73

About the Infectious Disease analysis team 74

Datamonitor Healthcare’s Consulting expertise 75

Datamonitor’s Therapeutic Consulting expertise 76

Key therapy team members 76

John Savopoulos , Director of Infectious Diseases 76

David Abramson, Therapeutic Lead Consultant 77

Disclaimer 78





Abstract

Introduction
The HIV and hepatitis C (HCV) treatment markets are among the fastest growing infectious disease sectors. As co-infection with HIV and HCV is becoming increasingly common, as a result of shared transmission routes, key players are faced with a series of challenges. These include driving compliance rates, overcoming drug interactions, and accessing high risk populations.

Scope
* Key opinion leader insight into treatment strategies for co-infected HIV/HCV patients

* Case studies featuring the leading global players: Roche, GlaxoSmithKline, Boehringer Ingelheim and Gilead

* Key data and detailed epidemiology of HIV and HCV in the seven major markets: the US, Japan, Germany, France, Italy, Spain, and the UK

* Review of current HIV and HCV markets, including key company market share

Report Highlights
HCV is the most prevalent chronic infection within the HIV cohort, infecting over 30% of HIV positive individuals. However, the HIV/HCV co-infected population is primarily comprised of difficult-to-treat patient groups, such as intravenous drug users (IDUs).

HIV/HCV patient potential is limited by poor compliance and low prevalence rates, limiting the incentive for novel product development. However, penetration of the co-infected market will enable companies to leverage their products into the wider HIV or HCV mono-infected populations.

Treatment of HIV/HCV co-infected patients is complicated by drug-drug interactions and the hepatotoxic side effects of certain HIV products. The design and development of a treatment package with proven efficacy in the co-infected population would provide physicians with a convenient treatment strategy.

Reasons to Purchase
* Identification of key co-infected high-risk patient populations will enable companies to design effective targeting strategies

* Evaluation of current treatment practices highlights areas of clinical unmet need and subsequent potential penetration strategies

* Detailed analysis of existing and pipeline products allows identification of opportunities for company collaboration in the co-infection market.



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