市場調査報告書：HIV治療動向

Abstract

Overview

Introduction

Despite several developments in efforts to tackle the spread of HIV, the total number of people living with HIV has continued to increase across the 6MM. However, significant advances in HIV disease understanding, treatment and management mean that the outlook for patients has considerably improved.

Scope

Current epidemiology of HIV in the six major markets, including prevalence, diagnosis rates and patients split by line of therapy and drug regimens
A detailed examination of the patient numbers on each line of therapy, their drug regimens and preferences
Evaluation of the factors determining prescription choices and their respective level of influence
An assessment of the perception of new products in development and of key unmet needs within HIV

Highlights

In the US and M5EU the total number of people living with HIV is continuing to increase. According to Datamonitor' s physician survey, the total number of diagnosed patients across the 6MM is 1.1 million, of which 18% are treatment-naïve and approx. 800.000 are currently receiving therapy

The complexity of HAART begins to increase as patients progress to later stages of therapy, with regimens consisting of up to 6 different drugs. Treatment also becomes much more individualized: Datamonitor' s research shows that the top 5 most popular regimens selected by physicians account for only 13% of patients in salvage therapy

Prescription choice is largely driven by patient and product-specific qualities, but the influence of these issues varies according to line of therapy. Efficacy and resistance profile exert an increasing influence as the patient becomes more treatment-experienced.

Reasons to Purchase

Identify the key factors underlying prescription choice for treatment of HIV
Examine the current unmet needs in the HIV market and identify opportunities for new product development
Enhance your commercial positioning through an improved understanding of the HIV market dynamics

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
  - Etiology
- 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
- Journals
- Websites
- Other
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
  - Disclaimer
- 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

HIV治療動向

Stakeholder Insight: HIV Therapy Dynamics

Abstract

Overview

Introduction

Scope

Highlights

Reasons to Purchase

Table of Contents