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Stakeholder Opinions: HIV - Reaching the 'Untapped' Patient Population


Description: Introduction In 2002, global estimates of HIV/Aids cases were 42 million (Unaids, 2002). Datamonitor believes that approximately 50% are undiagnosed and untreated - this represents a significant commercial opportunity for the pharma industry. Scope Key data and epidemiology of the seven major HIV therapeutic markets highlighting untreated ‘untapped’ population Overview of the limitations surrounding ‘untapping’ patient potential discussing issues such as patient presentation, screening and diagnosis Examination of a number of diagnostic and monitoring tools that vary in terms of ease of use, cost and accuracy Discussion of comprehensive initiatives for HIV therapeutic companies in both the public and private sector, based on key opinion leader interviews Report Highlights In all seven of the major HIV therapeutic markets, a significant proportion of the HIV and Aids patient population ‘escapes’ diagnosis and subsequent treatment. Companies need to be aware of this significant ‘untapped’ population in both existing and emergent markets. Presentation and diagnosis are two key areas that have been identified for HIV therapeutic stakeholders to focus on, especially, in regards to the latter, in light of the growth of the molecular diagnostic market for all areas of infectious diseases. Pharma companies looking to capture the untreated HIV population need to target both the public and private sectors. Public sector initiatives include partnerships with governments, international bodies and with patients, physicians and advocacy groups. Private sector collaborations, specifically with HIV diagnostic companies, should be nurtured. Reasons to Purchase Awareness of the sheer volume of the ‘untapped’ HIV population will confer an advantage to the key players in the HIV therapy and diagnostic sectors. Provides an insight into the HIV diagnostic and monitoring tools on the market, with a thorough discussion of their limitations and advantages. Presents comprehensive strategic recommendations with which to reach this untreated ‘untapped’ market.


Contents: TABLE OF CONTENTS

Chapter 1 EXECUTIVE SUMMARY 3
Scope of the analysis 3
Datamonitor insight into the disease HIV and AIDS ‘untapped’ markets 4
Estimated US figures for prevalence of total HIV and AIDS cases reveals a sector of 637,553 patients currently untreated (56.5%). Assuming 100% access and current treatment costs, this equates to an annual cumulative revenue loss of approximately $6.3bn (2002), a figure projected to accumulate to $12.2bn by 2010. Even gaining a small percentage of this large untapped market would lift current market value significantly. 4
Untapping patient potential will require companies to more actively address issues surrounding low rates of presentation and diagnosis. These areas of intervention are highly interdependant, presenting as a multifaceted challenge. Companies need to balance carefully their investment in funding certain initiatives against potential increases in revenue. 5
Diagnostic and monitoring tools, essential to treating existing and potential HIV patients vary widely in terms of cost, accuracy, ease and speed of use. In addition, the use of genotypic and phenotypic resistance testing to improve patient compliance is increasing. Datamonitor believes that underlying positive commercial drivers within these sectors will further ease access to the ‘untapped’ pool. 6
For potential collaboration, therapeutic companies should formulate clear objectives for both the public and the private sector. Public sector based initiatives include partnerships with governments, international bodies and patients, physicians and advocacy groups. Private sector based collaborations, specifically with HIV diagnostic companies focus on gaining access to latest technology but also the maintenance of market presence. 7
Summary 9
Key metrics 10

Chapter 2 QUANTIFYING UNTAPPED PATIENT POPULATIONS 16
The opportunity 16
Untapped HIV patient population in the US market 18
Untapped HIV patient population in the European market 21
Western Europe 22
Eastern Europe 23
Central Europe 24
Summary 24
Other regions 25
Post diagnosis: the untreated sector 25

Chapter 3 LIMITS TO PATIENT POTENTIAL 29
Factors affecting diagnosis of HIV 29
Presentation 30
Lifestyle and awareness 30
Education and perception of general public 32
Case study: UK 33
IDUs and needle exchange programs 34
MSM transmission 35
Heterosexual transmission 35
Other routes of transmission 35
Education and perception of physicians 36
Healthcare infrastructure and resources 37
Screening 37
Screening of high-risk individuals 38
Screening of pregnant women 39
Diagnosis 41
Treatment 41
Compliance to HIV therapy 41
Current compliance rates 42
Treatment eligibility 44

Chapter 4 DIAGNOSTICS AND MONITORING 45
Market overview 45
Key diagnostic and resistance tests 46
Diagnostic tests 47
Antibody testing 47
Antigen detection 49
Home diagnostic kits 50
Summary 51
Resistance testing 52
Phenotypic resistance tests 52
Genotypic resistance tests 53

Chapter 5 STRATEGIC PARTNERSHIPS 55
Partnerships with the public sector 55
Governments in the major markets 55
Case study: Abbott 57
Supranational organizations 57
Access to HIV diagnostics 57
Patients, physicians and advocacy groups 58
The tools of mass media 59
Case study: Schering-Plough 59
Raising compliance 60
Identification through treatment of comorbidities 61
Case study: GSK 62
Partnerships with other companies 62
Therapy-therapy collaborations 63
Therapy-diagnostic collaborations 63
Summary 64
APPENDIX A 65
List of tables 65
List of figures 65
Websites 68
Company websites 69
APPENDIX B 70
About Datamonitor 70
About Datamonitor Healthcare 70
Datamonitor Healthcare’s research and analysis methodologies 71
Datamonitor Healthcare’s therapy area capabilities 71
About the Infectious Disease analysis team 72
Datamonitor Healthcare’s Consulting expertise 73
Datamonitor’s Therapeutic Consulting expertise 74
Key therapy team members 75
John Savopoulos, Lead Analyst, Infectious Diseases 75
David Abramson, Therapeutic Lead Consultant 75
Disclaimer 76




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