Drug Overview
The Reyataz franchise comprises the standalone azapeptide protease inhibitor (PI) Reyataz (atazanavir; Bristol-Myers Squibb) and the fixed-dose combination of Reyataz and Tybost (cobicistat; Gilead), branded as Evotaz in both the US and EU. Reyataz is a once-daily boosted PI that is used in combination with other antiretroviral drugs for the treatment of HIV-1 infection. Tybost is a boosting agent to be used in combination with PIs as part of treatment regimens for HIV-1 infection. PIs block the activity of the HIV-1 protease enzyme, which inhibits cleavage of the Gag-Pol polyprotein precursor. This results in the production of immature, non-infectious virus.
Sales of the Reyataz franchise continue to fall due to loss of market share to single-tablet regimens (STRs), as well as to rival drugs Prezista (darunavir; Johnson & Johnson) and Tivicay (dolutegravir; ViiV Healthcare). This sales decline is set to continue due to Reyataz’s relegation to an “alternative” regimen in US and EU guidelines, as well as the approval of Symtuza ([darunavir + cobicistat + emtricitabine + tenofovir alafenamide (TAF)]; Johnson & Johnson), which is the first ever protease inhibitor-based STR for treatment-naïve and treatment-experienced patients.
Analyst Outlook
Sales of the Reyataz franchise, comprising of Reyataz (atazanavir; Bristol-Myers Squibb) and Evotaz ([atazanavir + cobicistat]; BristolMyers Squibb/Gilead), continue to fall due to loss of market share to single-tablet regimens (STRs), as well as to rival drugs Prezista (darunavir; Johnson & Johnson) and Tivicay (dolutegravir; ViiV Healthcare). This sales decline is set to continue due to Reyataz’s relegation to an “alternative” regimen in US and EU guidelines, as well as the approval of Symtuza ([darunavir + cobicistat + emtricitabine + tenofovir alafenamide (TAF)]; Johnson & Johnson), which is the first ever protease inhibitor-based STR for treatment naïve and treatment-experienced patients.
The availability of generics in the US (December 2017) and EU (March 2019) has also contributed to a severe drop in sales of Reyataz. While the Evotaz fixed-dose combination (FDC) will afford some protection to the franchise, as physicians are reluctant to increase patients’ pill burdens by providing cheaper generic atazanavir + a boosting agent in separate pills, the franchise’s role in the HIV treatment algorithm will continue to diminish as integrase strand transfer inhibitor (INSTI)-based options increasingly dominate early lines of therapy, and novel, lower-cost two-drug regimens gain uptake in the maintenance setting.
The Reyataz franchise comprises the standalone azapeptide protease inhibitor (PI) Reyataz (atazanavir; Bristol-Myers Squibb) and the fixed-dose combination of Reyataz and Tybost (cobicistat; Gilead), branded as Evotaz in both the US and EU. Reyataz is a once-daily boosted PI that is used in combination with other antiretroviral drugs for the treatment of HIV-1 infection. Tybost is a boosting agent to be used in combination with PIs as part of treatment regimens for HIV-1 infection. PIs block the activity of the HIV-1 protease enzyme, which inhibits cleavage of the Gag-Pol polyprotein precursor. This results in the production of immature, non-infectious virus.
Sales of the Reyataz franchise continue to fall due to loss of market share to single-tablet regimens (STRs), as well as to rival drugs Prezista (darunavir; Johnson & Johnson) and Tivicay (dolutegravir; ViiV Healthcare). This sales decline is set to continue due to Reyataz’s relegation to an “alternative” regimen in US and EU guidelines, as well as the approval of Symtuza ([darunavir + cobicistat + emtricitabine + tenofovir alafenamide (TAF)]; Johnson & Johnson), which is the first ever protease inhibitor-based STR for treatment-naïve and treatment-experienced patients.
Analyst Outlook
Sales of the Reyataz franchise, comprising of Reyataz (atazanavir; Bristol-Myers Squibb) and Evotaz ([atazanavir + cobicistat]; BristolMyers Squibb/Gilead), continue to fall due to loss of market share to single-tablet regimens (STRs), as well as to rival drugs Prezista (darunavir; Johnson & Johnson) and Tivicay (dolutegravir; ViiV Healthcare). This sales decline is set to continue due to Reyataz’s relegation to an “alternative” regimen in US and EU guidelines, as well as the approval of Symtuza ([darunavir + cobicistat + emtricitabine + tenofovir alafenamide (TAF)]; Johnson & Johnson), which is the first ever protease inhibitor-based STR for treatment naïve and treatment-experienced patients.
The availability of generics in the US (December 2017) and EU (March 2019) has also contributed to a severe drop in sales of Reyataz. While the Evotaz fixed-dose combination (FDC) will afford some protection to the franchise, as physicians are reluctant to increase patients’ pill burdens by providing cheaper generic atazanavir + a boosting agent in separate pills, the franchise’s role in the HIV treatment algorithm will continue to diminish as integrase strand transfer inhibitor (INSTI)-based options increasingly dominate early lines of therapy, and novel, lower-cost two-drug regimens gain uptake in the maintenance setting.
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