Biotech Values

[DewDiligence]

HIV Market Data from GILD’s 4Q09 CC

The HIV market continues to grow slowly but steadily in the US
and EU thanks to increased testing, which has been facilitated
by recent legislation (#msg-31419107), and new treatment
guidelines that recommend an earlier start to anti-retroviral
therapy according to the CD4 count (#msg-33124429).

GILD’s Atripla/Truvada franchise continues to take market share
from GSK’s ‡Epzicom/Kivexa, which is a very distant second
among nucleoside backbones. Moreover, GILD reported that the
newest agents to gain significant traction in the first-line setting—
MRK’s Isentress and JNJ’s Prezista—are used with Truvada 81%
and 91% of the time, respectively.

If there’s a negative here for GILD amid all the seemingly bullish
market-share trends, it’s that there are few remaining people to
be switched to a GILD regimen from a backbone of Epzicom/Kivexa
or Combivir. In the US, only about 100,000 such individuals remain.
Thus, from this point on, growth of GILD’s HIV franchise will be
highly dependent on overall growth in the HIV market.

Here are data** on penetration and market
share as provided by GILD on its 4Q09 CC:


US patients: All lines
189K on Atripla (33% share)
212K on Truvada (37% share)
†20K on Viread (3% share)
====
421K on tenofovir in some form (73% share)
157K on non-tenofovir regimens (27% share)
====
578K total patients, +4% year-over-year, +1% quarter-over-quarter


US patients: First-line only
Atripla or Truvada: 85% share (Atripla 53% share)


EU* patients: All lines
287K total patients, +6% year-over-year, +2% quarter-over-quarter


EU* patients: First-line only
Atripla or Truvada: 76% share in 4Q09
‡Kivexa: 10% share in 4Q09


*Top-5 EU countries: Germany, France, UK, Italy, Spain.
**As of the end of 3Q09 unless otherwise specified.
†Estimate by Dew.
‡Epzicom (US) and Kivexa (EU) are the same product: a combination of GSK’s Epivir and Ziagen.