The Human Immunodeficiency Virus (HIV) market is seeing growth due to the uptake of new premium-priced antiretroviral agents, particularly the latest single-tablet regimens (STRs) with improved side-effect profiles that place an emphasis on safety and tolerability. Our Current Treatment content provides deep insights drawn from a survey of 103 infectious disease specialists and internal medicine physicians regarding the current and anticipated use of HIV regimens, including the recently approved STR Genvoya (elvitegravir/emtricitabine/tenofovir alafenamide/cobicistat), by capturing patient and market share data, current prescribing trends, and anticipated changes in prescribing and treatment behavior in the United States today.

Table of contents

  • Human Immunodeficiency Virus - Current Treatment - Detailed, Expanded Analysis (US)
    • Physician Prescribing Practices
      • HIV Treatment Landscape: Delayed Starts, Effective Options
      • Patient Characteristics
        • Many HIV Patients Are Ill at Time of Their Diagnosis
        • Comorbidities and/or Other Relevant Attributes of HIV Patients Under Care (Survey Data)
        • HIV Patient Insurance Coverage by Physician Specialty (Survey Data)
        • CD4 Count of Newly Diagnosed HIV Patients at Time of Diagnosis (Survey Data)
      • Treatment Practices
        • Patient Characteristics at Time of Treatment Initiation
        • Factors That Influence Physicians' Prescribing Decisions (Survey Data)
        • Regimen Drug Class Patient Shares by HIV Diagnosis Subtype (Survey Data)
        • Primary Reason Why Diagnosed Patients Do Not Receive Treatment (Survey Data)
        • Patients Are Seeking Treatment Late
        • Newly Diagnosed Patient CD4 Counts at Time of ARV Therapy/Regimen Initiation (Survey Data)
        • Most Linked-to-Care HIV Patients Are Receiving Therapy
        • Average Number of Drug-Treated and Non-Drug-Treated Patients by Subtype (Survey Data)
        • Patients Are Being Prescribed Newer ARV Therapies/Regimens
        • Brand-Level Patient Share by HIV Diagnosis Subtype (Survey Data)
        • Brand-Level Patient Share for Physicians' "Other" Category (Survey Data)
        • Patient Share by Drug Type (Survey Data)
        • Patient Share by HIV ARV Brand (RWD: Claims)
        • Brand-Level Treatment Duration for Patients Who Discontinue or Switch
        • Average Brand Time from Initiation to Discontinuation (in Years) (Survey Data)
        • Nonpharmaceutical Approaches Are Not Applicable to HIV
        • Current HIV ARV Therapies Are Suitable for Almost All Patients
        • Most Patients Use Early-Line Regimens
        • Lines of Therapy by Patient Diagnosis Subtype (Survey Data)
        • HIV Patients Receive ARV Regimens Tailored to Their Comorbidities
        • The Most Commonly Prescribed ARV Combination Regimen by Patient Classification (Survey Data)
        • Prescribing Practices Are Similar in All Lines of HIV Therapy
        • Brand-Level Patient Share by Lines of Therapy (Survey Data)
        • Regimen Class Patient Share by Lines of Therapy (Survey Data)
        • Truvada PrEP for HIV Prevention
        • Prevalence of Truvada Prescribing for PrEP by Physician Specialty (Survey Data)
        • Patient Characteristics of Those Prescribed Truvada for PrEP (Survey Data)
      • Persistency and Compliance
        • HIV Patients' Issues with ARV Therapy/Regimen Persistency
        • Patient Compliance with ARV Therapies/Regimens at the Brand Level (Survey Data)
        • Patient Compliance with ARV Therapies/Regimens at the Brand Level (RWD: Claims)
        • One-Year Persistence by HIV ARV Therapy/Regimen (Survey Data)
        • One-Year Persistence by HIV ARV Therapy/Regimen: January-December 2015 (RWD: Claims)
        • Percentage of HIV Patients Who Switch or Cease ARV Therapy/Regimens (Survey Data)
      • Sequencing of Treatment
        • Many HIV Patients Switch for Improved Safety/Tolerability
        • Newly Diagnosed Patients Prescribed Step Therapy for Viral Suppression Before Switching to Maintenance Therapy (Survey Data)
        • Regimen Type Patient Share Following Atripla Discontinuation (Survey Data)
        • Patient Share Following Atripla Discontinuation (RWD: Claims)
        • Clinical Drivers for Patients to Switch Off Atripla (Survey Data)
        • Clinical Drivers for Prescription Switching to Genvoya (Survey Data)
      • Recent/Anticipated Changes in Brand Usage/Treatment Approach
        • HIV Physicians Plan to Keep Consistent with Patient Prescribing
        • Percentage of HIV Physicians Who Changed Treatment Approach and/or Management of HIV Patients (Survey Data)
        • Changes in Prescribing Habits of ID Specialists During the Past 12 Months (Survey Data)
        • Changes in Prescribing Habits of IM Physicians During the Past 12 Months (Survey Data)
        • Changes in Prescribing Habits of All Managing HIV Physicians During the Past 12 Months (Survey Data)
        • Anticipated Prescribing Changes for Newly Diagnosed Patients 12 Months from Now (Survey Data)
        • Anticipated Prescribing Changes for Patients Who Switch ARV Therapy/Regimen 12 Months from Now (Survey Data)
        • Anticipated Prescribing Changes for Treatment-Experienced Patients 12 Months from Now (Survey Data)
        • Physician Familiarity with Key HIV Pipeline Products (Survey Data)
        • Brand-Level Anticipated Physician Prescribing Changes for Next Five Years (Survey Data)
    • Physician Insight on Medical Practice
      • Physicians and Manufacturers Are Driven by Safety/Tolerability
      • Drivers of Treatment Selection
        • ID Specialists Prescribe Based on Clinical Criteria and Less by Costs
        • TAF-Containing Regimens Favored Only by Specialists
        • Importance of Treatment Guidelines in HIV Physicians' Prescribing Decisions (Survey Data)
        • Poll of ID Specialists' Prescribing Factors and Decisions (Survey Data)
        • Poll of IM Physicians' Prescribing Factors and Decisions (Survey Data)
        • Safety and Efficacy Are the Strongest Drivers for Prescribing
        • Biggest Perceived Strengths of HIV ARV Brands (Survey Data)
        • Atripla Prescribing Held Back Due to Multiple Safety/Tolerability Concerns
        • ID Specialist-Cited Obstacles in ARV Prescribing (Survey Data)
        • IM Physician-Cited Obstacles in ARV Prescribing (Survey Data)
        • ID Specialists' Awareness of Brand Limitations
        • Physicians' Perception of Weakness in HIV ARV Brands (Survey Data)
        • Poor Patient Compliance Is Driven by Tolerability Issues
        • Reasons Why HIV Patients Discontinue Therapy (Survey Data)
      • Face-to-Face Product Detailing Effectiveness
        • HIV ARV Sales Representatives Perform Well but with a Minority of Physicians
        • Atripla, Stribild, and Truvada Dominate Sales Representative Visits for HIV ARVs
        • Sales Representative Access to Physicians in All Clinical Settings (Survey Data)
        • The HIV Brands for Sales Representatives' Visits with Physicians (Survey Data)
        • The Average Frequency of Brand-Level Sales Contact per Six-Month Period (Survey Data)
        • The Frequency of Brand-Level Sales Contacts per Six-Month Period (Survey Data)
        • The Frequency of Sales Representatives' Visits by ARV Brand (Survey Data)
        • Sample and Voucher Access for HIV ARVs (Survey Data)
        • HIV Physicians Are Satisfied with Sales Representative Interactions for ARVs
        • Physician Satisfaction with Sales Representative by Brand (Survey Data)
        • Sales Representatives Discuss Safety with Physicians
        • Brand-Level Message Discussed During Sales Representative Visit (Survey Data)
        • Brand-Level Message Discussed During Sales Representative Visit (Survey Data) (Cont.)
    • Methodology
      • Primary Market Research Methodology
      • Physician Specialty (Survey Data)
      • Regional Location of Physician Practice (Survey Data)
      • Location of Physician Practice by State (Survey Data)
      • Average Number of Years Physicians Have Been in Practice Postresidency (Survey Data)
      • Average Number of HIV Patients Managed by Physicians by Diagnosis Subtype (Survey Data)
      • Distribution of Managing HIV Physicians' Primary Practice Type (Survey Data)
      • Claims Data Methodology
    • Appendix
      • Primary Market Research
        • Average Physician Familiarity Rating with Key HIV Pipeline Products
        • Physician Satisfaction of Sales Representatives' Knowledge of HIV by Brand
        • Sales Representative Access to Physicians in All Clinical Settings
        • Physician Satisfaction of Sales Representatives' Knowledge of the ARV Brand
        • Physician Satisfaction of Sales Representatives' Ability to Address Questions on Product Logistics by Brand
        • Physician Satisfaction of Sales Representative by Brand for Overall Effectiveness in Bringing Value to Their Practice
        • HIV Physicians' Obstacles in ARV Prescribing
        • Average Importance of Treatment Guidelines in HIV Physicians' Prescribing Decisions
        • Poll of HIV Physicians' Prescribing Factors and Decisions
        • Averages of HIV Physicians' Prescribing Factors and Decisions

Author(s): Steven F. Trueman, PhD

Steve is a member of Decision Resources Group’s Infectious, Niche, and Rare Diseases (INRD) team. Currently, he provides analyses and content production on infections caused by the human immunodeficiency virus (HIV) and the hepatitis C virus (HCV).

Steve conducted his postdoctoral research on models of neurodegenerative disease in the Department of Biochemistry at Brandeis University. He earned a doctorate in biochemistry from the University of Massachusetts Medical School, Graduate School of Biomedical Sciences, where he studied protein translocation into the endoplasmic reticulum.