>Using GS9350 rather than Ritonavir will allow GILD to have all the rights to a single once-daily treatment for HIV, with potentially a smaller pill (GS9350 will replace 100mg Ritonavir), and a new PK enhancer which is devoid of HIV activity.<
Correct on all counts but not quite a complete answer, IMO.
The problem with using Ritonavir in a combination pill intended for the first-line setting goes beyond the mere fact that Ritonavir has anti-HIV activity and is thereby subject to the emergence of resistance.
The bigger problem is that is that Ritonavir is part of Kaletra and it is generally used with Reyataz. Kaletra and Reyataz are the second- and third-most commonly used adjuncts to Truvada (Sustiva is #1), and hence a combo pill from GILD that contained Truvada + Elvitegravir + Ritonavir would have run into a brick wall of resistance (the human kind!) from clinicians who wanted to retain the option of going to Truvada + Reyataz or Truvada + Kaletra in the next line of treatment.
“The efficient-market hypothesis may be
the foremost piece of B.S. ever promulgated
in any area of human knowledge!”
