Hello Folks,
I have a thought about the bear case for AGPH ... just a speculation as to why a lot of possibly smart money is betting against their continued success. Note: this is nothing new. I'm just re-raising an issue we've discussed quite a bit before on the thread - the assumption that the PI market will continue to grow, and the impact on that market of new information on PI side effects such as lipidystrophy / buffalo hump / Crix belly.
For the sake of argument, I'll just focus on the US market. All indications are that the PI market in the US will continue to grow, and substantially, over the next few years.
There are an estimated 850-1,000K HIV-infected people in the US. 250K are being treated with anti-retroviral therapy (200K of those on PI + RTI's, the other 50K on RTI's only). Another 300K are diagnosed, but untreated, and an estimated 250-400K remain undiagnosed.
One of the arguments for continued growth of the PI market is there's a lot of room for expansion. Leaving aside dual PI use, there're the 50K patients being treated with RTI's, but not PI's, and then there are 300K diagnosed, but untreated. There's no question PI's save lives, and increase the quality of patient's lives. "Hit hard, hit early" seems to be gaining acceptance.
However, as the target patient set expands into asymptomatic, but HIV infected, diagnosed patients, there's a different calculation on the part of the patient, doctor, and payer, and one of the factors weighed is the side effect profile of the drug(s).
So, information about the side effects of PI's in chronic use could have a big influence of whether or not PI use expands significantly in the diagnosed, asymptomatic patients. For example, does anybody have any information about what's going to be presented on PI chronic use side effects in Geneva in a few weeks?
(compliance and resistance information would be relevant, as well)
Peter
p.s., btw, the argument for Viracept's increasing contribution to AGPH,
- increasing market share among existing PI's
- increasing PI market overall
- Viracept ability to maintain "gold standard" position when VRTX/GLX product is on the market
- sales outside the US
- increasing margin due to manufacturing volumes and learning curve
- stable pricing
I think the case for all of the above are relatively sound, but need to be continuously tested to see if the data continues to support that conclusion. |
