Table of Contents
- ABOUT DATAMONITOR HEALTHCARE
- About the Infectious diseases and Respriatory pharmaceutical analysis
team
- CHAPTER 1 EXECUTIVE SUMMARY
- Scope of the analysis
- Datamonitor insight into the HIV market
- Related reports
- Upcoming reports
- CHAPTER 2 INTRODUCTION AND SCOPE
- Coverage of the Stakeholder Insight Survey
- Disease definition & epidemiology
- Diagnosis and treatment rates
- Treatment options and trends
- Key prescribing influences
- Improving treatment outcomes and new product development
- CHAPTER 3 COUNTRY TREATMENT TREES
- Introduction
- US
- France
- Germany
- Italy
- Spain
- UK
- CHAPTER 4 EPIDEMIOLOGY AND PATIENT SEGMENTATION
- Disease definition
- Disease prevalence
- HIV prevalence in the six major markets
- Epidemiological trends
- Patient segmentation
- By treatment experience - treatment-naïve and treatment-experienced
population
- Pre- or post-HAART patients
- Number of resistance mutations
- CHAPTER 5 DIAGNOSIS AND TREATMENT RATES
- Presentation and diagnosis
- Diagnostic tests
- Genotypic and phenotypic testing for resistance
- Genotypic assays
- Phenotypic assays
- Awareness campaigns have increased diagnosis rates
- Treatment rates
- CD4 T cell count
- Viral load
- Factors influencing the initiation of treatment
- CHAPTER 6 TREATMENT OPTIONS AND TRENDS
- Treatment options
- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Non-nucleoside reverse transcriptase inhibitors
- Protease inhibitors
- Entry inhibitors
- Prescribing trends
- First-line therapy
- Second-line therapy
- Third-line therapy
- Fourth-line therapy
- Fifth-line to salvage therapy
- Treatment failure and switching therapy
- Resistance
- Compliance issues
- GI side effects
- Adverse lipid effects
- Lipodystrophy
- Dyslipidemia
- Renal dysfunction
- CNS side effects
- Drug interactions
- Hyperbilirubinemia and jaundice
- Pregnancy
- CHAPTER 7 PRESCRIBING INFLUENCES AND BRAND ASSESSMENT
- Factors influencing physician decision making
- Efficacy
- Patient resistance profile
- Clinical trial data
- Quality of life considerations
- Pill burden and dosing frequency
- Side effects
- Treatment guidelines/hospital protocol
- Preservation of options for later lines of therapy
- Cost
- Physician perception of key brands
- Fixed dose combinations
- Protease inhibitors
- CHAPTER 8 IMPROVING TREATMENT OUTCOMES AND NEW PRODUCT DEVELOPMENT
- Treatment outcomes
- Unmet needs
- Resistance remains the key unmet need for antiretroviral therapy
- Toxicity
- Unmet needs for FDCs and PIs
- New product development
- Awareness
- TMC125 and TMC278
- MK-0518 (raltegravir)
- GS-9137 (elvitegravir)
- Selzentry/Celsentri (maraviroc)
- Vicriviroc
- BIBLIOGRAPHY
- APPENDIX A
- Physician research methodology
- Physician sample breakdown
- US
- France
- Germany
- Italy
- Spain
- UK
- Contributing experts
- APPENDIX B
- The survey questionnaire
- Epidemiology and Patient Segmentation
- Diagnosis
- Treatment
- Product Profiles
- Products In Development
- Demographics
- Name of opinion leader
- Hospital
- Hospital City/Address
- List of Tables
- Table 1: HIV infected population in the six major markets, 2005
- Table 2: HIV infections by transmission category in the US, 2005
- Table 3: Overview of the nucleoside reverse transcriptase inhibitors,
2007
- Table 4: Overview of the NNRTIs, 2007
- Table 5: Overview of currently marketed PIs, 2007
- Table 6: Overview of the FDCs
- Table 7: Overview of top five first-line regimens selected by
physicians across the six major markets, 2007
- Table 8: Overview of top five second-line regimens selected by
physicians across the six major markets, 2007
- Table 9: Overview of the top five drug regimens for third-line
therapy, as selected by physicians, 2007
- Table 10: Overview of the top five drug regimens for fourth-line
therapy, as selected by physicians 2007
- Table 11: Overview of the top five drug regimens for
fifth-line-salvage therapy, as selected by physicians 2007
- Table 12: HIV treatment guidelines available for the six major
markets, 2007
- Table 13: Level of awareness of developmental compounds, 2007
- Table 15: Probable line of therapy upon launch for developmental
compounds, 2007
- Table 15: Probable line of therapy upon launch for TMC125, 2007
- Table 16: Probable line of therapy upon launch for TMC278, 2007
- Table 17: Probable line of therapy upon launch for raltegravir, 2007
- Table 18: Probable line of therapy upon launch for elvitegravir, 2007
- Table 19: Probable line of therapy upon launch for Selzentry, 2007
- Table 20: Probable line of therapy upon launch for vicriviroc, 2007
- Table 21: US physician sample breakdown, 2007
- Table 22: France physician sample breakdown, 2007
- Table 23: Germany physician sample breakdown, 2007
- Table 24: Italy physician sample breakdown, 2007
- Table 25: Spain physician sample breakdown, 2007
- Table 26: UK physician sample breakdown, 2007
- List of Figures
- Figure 1: Treatment tree for US part A
- Figure 2: Treatment tree for US part B
- Figure 3: Treatment tree for France part A
- Figure 4: Treatment tree for France part B
- Figure 5: Treatment tree for Germany part A
- Figure 6: Treatment tree for Germany part B
- Figure 7: Treatment tree for Italy part A
- Figure 8: Treatment tree for Italy part B
- Figure 9: Treatment tree for Spain part A
- Figure 10: Treatment tree for Spain part B
- Figure 11: Treatment tree for UK part A
- Figure 12: Treatment tree for UK part B
- Figure 13: Regional HIV and AIDS overview, 2006
- Figure 14: HIV lifecycle
- Figure 15: Trends in routes of transmission in the US, 2001-05
- Figure 16: Number of newly diagnosed cases of HIV infection by
transmission group and year of report in Western Europe (13 countries),
1998-2005
- Figure 17: Percentage of treatment-naïve and treatment-experienced HIV
patients, 2007
- Figure 18: Response to treatment in the first year of HAART, 1996-2002
- Figure 19: United Kingdom CHIC study: extensive risk of failure
- Figure 20: Primary drug resistance in the US: March 2003-October 2006
- Figure 21: Mutations that affect susceptibility to NRTIs
- Figure 22: Mutations that affect susceptibility to NNRTIs
- Figure 23: Mutations that affect the susceptibility to PIs
- Figure 24: PI resistance across the six major markets, 2007
- Figure 25: Percentage of total HIV-infected population that is
successfully diagnosed, 2007
- Figure 26: Advantages and disadvantages of genotypic and phenotypic
assays
- Figure 27: Factors that influence resistance testing in patients, 2007
- Figure 28: Resistance testing by country, 2007
- Figure 29: Newly diagnosed patients versus follow-up, 2007
- Figure 30: Percentage of treatment-naïve and treatment-experienced HIV
patients, 2007
- Figure 31: CD4 counts at which therapy is initiated, 2007
- Figure 32: Other criteria used by physicians to initiate treatment,
2007
- Figure 33: Overview of sales by class,2002-06
- Figure 34: Timeline of the development of the HIV market, 1985-2015
- Figure 35: Percentage of patients receiving each line of therapy, 2007
- Figure 36: FDCs reduce pill burden
- Figure 37: Mean percentage of patients receiving each first line
regimen
- Figure 38: Mean percentage of patients receiving each second-line
regimen
- Figure 39: Mean percentage of patients receiving each third-line
regimen
- Figure 40: Mean percentage of patients receiving each fourth-line
regimen
- Figure 41: Mean percentage of patients receiving each fourth-line
regimen
- Figure 42: Reasons for switching HIV therapy, 2007
- Figure 43: Factors influencing prescription choice for first to third
lines of therapy, 2007
- Figure 44: Factors influencing prescription choice from fourth-line
onwards, 2007
- Figure 45: Overview of recommendations given by US and UK guidelines
- Figure 46: Brand map for fixed dose combinations, 2007
- Figure 47: Brand map for protease inhibitors, 2007
- Figure 48: Combined brand map for protease inhibitors and fixed dose
combinations, 2007
- Figure 49: Drug classes most likely to be used in combination with
TMC125, 2007
- Figure 50: Drug classes most likely to be used in combination with
TMC278, 2007
- Figure 51: Drug classes most likely to be used in combination with
raltegravir, 2007
- Figure 52: Drug classes most likely to be used in combination with
elvitegravir, 2007
- Figure 53: Drug classes most likely to be used in combination with
Selzentry
- Figure 54: Drug classes most likely to be used in combination with
vicriviroc, 2007
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