Despite >37m people currently living with #HIV, the significant progress made in terms of development of new antiretroviral treatment regimens in recent years gives significant hope to patients and people at risk of infection.

Let’s take a look at a couple of the latest antiretrovirals, Gilead’s BIKTARVY and ViiV’s DOVATO.

Despite >37m people currently living with #HIV, the significant progress made in terms of development of new antiretroviral treatment regimens in recent years gives significant hope to patients and people at risk of infection.

Let’s take a look at a couple of the latest antiretrovirals, Gilead’s BIKTARVY and ViiV’s DOVATO.

BIKTARVY continues to drive the HIV market

Great news for Gilead and its triple treatment approach! BIKTARVY continues to demonstrate growth across its launched markets, having reached blockbuster status in 2018 and projected to bring >USD 7 bn in 2023. KOLs and HIV-treating physicians (mostly in the US) anticipate that BIKTARVY will be their treatment of choice both for naïve and switch patients in the next 2-3 years.

DOVATO likely to be niched to maintenance stage…

ViiV’s DOVATO is the new dual-regimen treatment seeking to put some “pressure” on BIKTARVY. Although DOVATO demonstrated an ability to achieve and maintain viral load suppression in HIV-infected individuals (GEMINI and TANGO studies), overall, questions / reluctance remain in terms of substituting triple therapy with dual therapy, even in maintenance stage. Switching a patient under control on triple to dual therapy needs solid justification for payers to approve (especially in the US); furthermore, switching patients on BIKTARVY to dual regimens (e.g. DOVATO) currently not viewed favourably by many physicians / patients (exceptions could appear for pts who gain excessive weight on triple).

A general growing perception (justified or not) also exists, supporting the notion that triple Tx is better than dual and has lower chances of failures (emergence of resistance).

…but might compete with BIKTARVY outside the US

Lower cost of dual therapy vs. triple could spur increased use of DOVATO outside the US, increasing its market share. Furthermore, DOVATO’s better side effect profile vs. BIKTARVY could also support the increased use of the former. Finally, demonstration that a switch from BIKTARVY to DOVATO is safe, especially in real-world setting, where pts often miss doses would strongly support a switch to DOVATO.

A number of KOLs and industry experts believe that ViiV should also be focusing on maximizing the use of DOVATO for the treatment of the naïve population, rather than on “switch” patients, and convince physicians that use of dual ART (DOVATO) is a valid choice vs. triple (BIKTARVY).

Overall, great news for patients!

Irrespective of whether DOVATO manages to upset BIKTARVY’s position (having higher chances of doing so outside the US) or whether BIKTARVY and Gilead continue to be ultra-successful, both of these drugs constitute significant advancements in the treatment of HIV infection.

High prices for these lifelong treatments do however raise some worries with payors across the globe; as always, there are no easy solutions but both Gilead and ViiV appear committed to expanding access to their drugs.

#aids #hiv #antiretrovirals