Several new drug treatments and an increase in the number of patients diagnosed are going to lead to significant growth in the HIV market, according to a new report from consultancy firm Datamonitor.

The research suggests that the HIV market will grow from $7.1 billion in 2005 to an estimated $10.6 billion in 2015, driven by a combination of several factors, including a rise in the number of patients, and the launch of several new medicines and drug classes “which offer new hope to patients who otherwise would have at-best limited, but perhaps no therapeutic options left at all.”

Datamonitor also notes that “despite countless efforts by governments and NGOs, the total number of people living with HIV continues to increase. An estimated 2.1 million people in North America and Western Europe were living with HIV in 2006, up from 1.9 million in 2004. Over the past year alone, a “staggering” 65,000 patients were newly infected and 30,000 patients were reported to have died from AIDS.

However, Datamonitor infectious diseases analyst Mansi Shah notes that “at the same time, advances in antiretroviral therapy have turned HIV from a universally-feared ‘death sentence’ into a chronic disease with an average life expectancy similar to that of type 2 diabetes.” As new lines of therapy become available, patients will have a greater choice, “mercifully leading to a decline of the HIV/AIDS mortality rate.”

Atripla leads way for new treatments

Despite the expected loss of patent protection for the majority of existing drugs over the next 10 years, Datamonitor forecasts the HIV market to grow to the aforementioned $10.6 billion, helped by recently launched products such as Merck & Co’s Atripla, a once-daily, triple therapy that is delivered in a single tablet and combines Bristol-Myers Squibb's Sustiva (efavirenz) and Gilead's Emtriva (emtricitabine) and Viread (tenofovir)

New classes of drugs such as Pfizer’s Celsentri (maraviroc), the first CCR5 inhibitor, and Merck & Co’s integrase inhibitor Isentress (raltegravir), which are expected to be launched in 2007 and 2008 respectively, are to be used- at least initially- in late-stage therapy, a market that is currently dominated by Roche’s Fuzeon (enfuvirtide), the only entry inhibitor approved so far, notes Datamonitor. However, it notes that Fuzeon’s “cumbersome administration” – it has to be injected twice daily and frequently causes side effects such as injection site reactions – led to a slow uptake, with first year sales of only $35 million in 2003 and although that figure increased to $249 million in 2006, its use is still restricted because of its high cost and the limited number of patients in salvage therapy.

As a result, the newer products, such as Celsentri, Isentress and new generation protease inhibitors such as Tibotec’s Prezista (darunavir), all of which are orally bio-available and less expensive, will have a significantly negative impact on the sales of Fuzeon and despite the latter’s “proven synergy” with some of these new treatments, Datamonitor expects its use to become even more limited to patients with no other available treatment options.

Ms Shah concluded by saying that the majority of new products will at least initially be reserved for use in late-stage therapy but “nonetheless their availability will extend treatment options for patients with more advanced HIV and those with AIDS.”