The HIV therapy market is growing as a result of 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 253 infectious disease specialists, internal medicine physicians, and general practitioners in the EU5 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.

Table of contents

  • Human Immunodeficiency Virus - Current Treatment - Detailed, Expanded Analysis (EU5)
    • Physician Prescribing Practices
      • The EU5 HIV Treatment Landscape: Effective Options and Late Starts
      • Patient Characteristics
        • Many HIV Patients Are Diagnosed with Low CD4 Cell Levels
        • Comorbidities and/or Other Relevant Attributes of HIV Patients
        • CD4+ Cell Count of Newly Diagnosed HIV Patients at the Time of Diagnosis
      • Treatment Practices
        • Single-Tablet Regimens Are the Key Choice Across Patient Subgroups
        • Factors That Influence Physicians' Prescribing Decisions
        • Patient Shares for Newly Diagnosed Patients by Drug Class
        • Patient Shares for Previously Diagnosed Switch Patients by Drug Class
        • Patient Shares for Previously Diagnosed Nonswitch Patients by Drug Class
        • Primary Reason Why Diagnosed Patients Do Not Receive Treatment
        • EU5 Physicians Are Following Treatment-at-Diagnosis Guidelines
        • Newly Diagnosed Patient CD4+ Cell Counts at Time of ARV Therapy Initiation
        • High Drug-Treatment Rates for Patients Linked to Care
        • Average Number of Drug-Treated and Non-Drug-Treated Patients by Subpopulation in France
        • Average Number of Drug-Treated and Non-Drug-Treated Patients by Subpopulation in Germany
        • Average Number of Drug-Treated and Non-Drug-Treated Patients by Subpopulation in Italy
        • Average Number of Drug-Treated and Non-Drug-Treated Patients by Subpopulation in Spain
        • Average Number of Drug-Treated and Non-Drug-Treated Patients by Subpopulation in the United Kingdom
        • Average Drug-Treatment Rates by Country
        • Physicians Are Tailoring ARV Treatment to Patient Needs
        • Brand-Level Patient Shares for Newly Diagnosed Patients by Country
        • Brand-Level Patient Shares for Previously Diagnosed Switch Patients by Country
        • Brand-Level Patient Shares for Previously-Diagnosed Nonswitch Patients by Country
        • Brand-Level Total Patient Shares by Country
        • Regimen-Level Total Patient Shares by Country
        • Likelihood of Pharmacy Level Generic Substitution by Country
        • EU5 HIV Physicians Manage Patients for Multiple Years
        • Average Duration Patients Remain Under Management of Their HIV Physician by Country
        • Nonpharmaceutical Approaches Are Not Applicable to HIV
        • Current HIV ARV Therapies/Regimens Suitable for Most Patients
        • Many Patients Use Early-Line Regimens
        • Lines of Therapy by Patient Diagnosis Subtype and Country
        • HIV Patients Are Prescribed Regimens Tailored to Their Comorbidities
        • The Most Commonly Prescribed ARV Regimen by Patient Classification in the EU5
        • The Most Commonly Prescribed ARV Regimen by Patient Classification in France
        • The Most Commonly Prescribed ARV Regimen by Patient Classification in Germany
        • The Most Commonly Prescribed ARV Regimen by Patient Classification in Italy
        • The Most Commonly Prescribed ARV Regimen by Patient Classification in Spain
        • The Most Commonly Prescribed ARV Regimen by Patient Classification in the United Kingdom
        • Atripla Use Declines in Later Lines of Therapy
        • Brand-Level Patient Shares of First-Line Therapies by Country
        • Brand-Level Patient Shares of Second-Line Therapies by Country
        • Brand-Level Patient Shares of Third-Line Therapies by Country
        • Truvada for HIV PrEP in the EU5
        • Prescribing of Truvada for HIV PrEP by Country
        • Types of Patients Prescribed Truvada for HIV PrEP by Country
      • Persistency and Compliance
        • HIV Patients Have Trouble with Persistency and Compliance
        • Average Patient Compliance by HIV ARV Therapy/Regimen in the EU5
        • One-Year Persistence by HIV ARV Therapy/Regimen in the EU5
        • One-Year Persistence by HIV ARV Therapy/Regimen in France
        • One-Year Persistence by HIV ARV Therapy/Regimen in Germany
        • One-Year Persistence by HIV ARV Therapy/Regimen in Italy
        • One-Year Persistence by HIV ARV Therapy/Regimen in Spain
        • One-Year Persistence by HIV ARV Therapy/Regimen in the United Kingdom
        • Percentages of EU5 HIV Patients Who Ceased or Switched Their ARV Therapy/Regimen
      • Sequencing of Treatment
        • Tolerability Is a Key Driver in the Sequencing of Treatment
        • Newly Diagnosed Patients Prescribed Step Therapy for Viral Suppression Before Switching to Maintenance Therapy
        • EU5 Regimen Type Patient Share Following Atripla Discontinuation
        • Clinical Drivers for Discontinuing Atripla
        • Clinical Drivers for Switching to Genvoya
      • Recent/Anticipated Changes in Brand Usage/Treatment Approach
        • EU5 Physicians Plan to Increase STR Use
        • Percentage of EU5 Physicians Who Changed Approach and/or Management of HIV Patients
        • Changes in HIV Prescribing Habits During the Past 12 Months by Country
        • Anticipated Prescribing Changes for Newly Diagnosed Patients 12 Months from Now by Country
        • Anticipated Prescribing Changes for Switch Patients 12 Months from Now by Country
        • Anticipated Prescribing Changes for Treatment-Experienced Patients 12 Months from Now by Country
        • EU5 Physicians' Familiarity with Key HIV Pipeline Agents
        • EU5 Physicians' Anticipated Prescribing Changes over Next Five Years by ARV Therapy/Regimen
    • Physician Insight on Medical Practice
      • Manufacturers and Physicians Are Focusing More on Tolerability
      • Drivers of Treatment Selection
        • Clinical Criteria and Treatment Guidelines Drive HIV Prescribing
        • National Guidelines a Key Driver of HIV Prescribing
        • Average Importance of Treatment Guidelines in HIV Therapy/Regimen Prescribing by Country
        • Factors That Influence Physicians' HIV Disease Management by Country
        • Clinical Data Support Drives HIV Prescribing
        • Average EU5 Physician-Perceived Strengths of ARV Brands
        • French Physician-Perceived Strengths of ARV Brands
        • German Physician-Perceived Strengths of ARV Brands
        • Italian Physician-Perceived Strengths of ARV Brands
        • Spanish Physician-Perceived Strengths of ARV Brands
        • U.K. Physician-Perceived Strengths of ARV Brands
        • Atripla's Uptake Constrained by Tolerability Issues
        • Obstacles to the Uptake of HIV ARV Brands in the EU5
        • Obstacles to the Uptake of HIV ARV Brands in France
        • Obstacles to the Uptake of HIV ARV Brands in Germany
        • Obstacles to the Uptake of HIV ARV Brands in Italy
        • Obstacles to the Uptake of HIV ARV Brands in Spain
        • Obstacles to the Uptake of HIV ARV Brands in the United Kingdom
        • EU5 HIV Physicians Are Generally Aware of Brand Limitations
        • Perceived Weaknesses of HIV ARV Brands According to EU5 Physicians
        • Perceived Weaknesses of HIV ARV Brands According to French Physicians
        • Perceived Weaknesses of HIV ARV Brands According to German Physicians
        • Perceived Weaknesses of HIV ARV Brands According to Italian Physicians
        • Perceived Weaknesses of HIV ARV Brands According to Spanish Physicians
        • Perceived Weaknesses of HIV ARV Brands According to U.K. Physicians
        • Poor Patient Compliance Driven by Tolerability and Patient Choice
        • Factors Driving Patients' Discontinuation of ARV Therapy
      • Effectiveness of Face-to-Face Product Detailing
        • HIV Sales Representatives Bring Value to Most Physicians' Practices
        • Sales Representatives Are Most Active in Spain
        • Sales Representatives' Access to EU5 Physicians
        • The HIV Brands for Sales Representatives' Visits with EU5 Physicians
        • Average Frequency of Brand-Level Sales Representative Visits per Six-Month Period
        • Frequency of Sales Representatives' Visits by ARV Brand in the EU5
        • Frequency of Sales Representatives' Visits by ARV Brand in France
        • Frequency of Sales Representatives' Visits by ARV Brand in Germany
        • Frequency of Sales Representatives' Visits by ARV Brand in Italy
        • Frequency of Sales Representatives' Visits by ARV Brand in Spain
        • Frequency of Sales Representatives' Visits by ARV Brand in the United Kingdom
        • EU5 Physicians Are Generally Satisfied with HIV Brand Sales Representatives
        • EU5 Physician Satisfaction with Sale Representatives by Brand
        • Sales Representatives Discuss Convenience and Proven Track Record with Physicians
        • Brand-Level Messaging Discussed During Sales Representatives' Visit
    • Methodology
      • Primary Market Research Methodology
      • Surveyed Physicians' HIV Clinical Practices by Country
      • Proportion of U.K. Physicians Practicing Within vs. Outside of London
      • HIV Physicians' Specialty by Country
      • HIV Physicians' Specialty in Germany
      • Average Number of Years HIV Physicians Practiced Postresidency by Country
      • HIV Physicians' Type of Primary Practice by Country
      • Abbreviations
    • Appendix
      • Primary Market Research
        • Other HIV ARV Brands Prescribed by EU5 Physicians
        • EU5 Physicians' Familiarity with Key HIV Pipeline Agents
        • Importance of Treatment Guidelines in HIV Therapy/Regimen Prescribing by Country
        • Mean Frequency of Brand-Level Sales Representatives' Visits per Six-Month Period
        • EU5 Physicians' Satisfaction with Sales Representatives' Knowledge of HIV by Brand
        • EU5 Physicians' Satisfaction with Sales Representatives' Knowledge of the ARV Brand
        • EU5 Physicians' Satisfaction with Sales Representatives' Ability to Address Questions on Product Logistics by Brand
        • EU5 Physicians' Satisfaction with Sales Representatives' Overall Effectiveness in Bringing Value to Their Practice by Brand
        • Factors That Influence Physicians' Management of HIV by Country

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.