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Replies to #88666 on Biotech Values
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ciotera

01/08/10 11:27 AM

#88668 RE: DewDiligence #88666

there were two points of contention, if you want to call it that, and strangely neither of them are what you re-capped:

(1) the market is moving away from PIs because they are viewed as having a low resistance barrier - that is wrong - PIs when boosted (which is almost always in clinical practice) have a very high resistance barrier. Of course I agree that the market is moving away from them but it's because of convenience in case of Atripla and tolerability in case of Isentress, and it's NEVER because of resistance because both evarirenz and raltegravir are inferior to boosted PIs in terms of resistance.

(2) Gilead is going to retain its dominant position in early lines because nothing is going to replace Truvada and they are combining it into FDRs - not 100% certain if the paradigm shifts to nuke sparing regimens.

As far as showing you data, I can only tell you what is the perception out there from having talked to dozens of infectious disease specialists. There were a few boosted PI vs. unboosted PI studies that invariably found a resistance benefit to boosting, but I don't think any of them involved Reyataz. I think it was Kaletra or Lexiva/r vs. unboosted nelfinavir.