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Biotech / Medical : Indications -- HIV -- Ignore unavailable to you. Want to Upgrade?

To: Elroy Jetson who wrote (84)	2/21/2009 8:51:16 PM
From: DewDiligence_on_SI	Read Replies (2) \| Respond to of 155

>As the binding moiety of each drug is different, and the pathways blocked can be different, you don't need to combine a pyrimidine analog only with a purine analog.< Agree that this is not a strict requirement; however, all else being equal, a purine+pyrimidine (e.g. Truvada) is probably a better bet than two pyrimidines (e.g. Combivir). >The purine nucleotide Viread is a powerful combination with the purine nucleoside Didanosine. The unexpected effect was the increase in CD4 count is less than expected, with actual declines in those with high CD4 levels. I think this has been over-generalized into a problem in combining drugs with similar a analog structure.< Nonetheless, there has been no commercially successful cocktail based on two pyrimidines since Combivir was launched 12 years ago. Who would want to bet on such an approach now? >In practice I don't see generous amount of value created by a single large tablet in place of several smaller ones…< I think you’re flat-out dead wrong on this point—a single qD tablet is the Holy Grail in HIV therapy. Any regimen that cannot be formulated as a single qD tablet will incur a serious competitive disadvantage, IMO. >While there may be some cost savings in packaging and inventory, I believe much of the "popularity" of a combo drug like Atripla is an illusion bought at the expense of profitability.< A single tablet improves compliance and saves the patient money on copays. I’m surprised someone as knowledgeable as you are about this field would overlook or dismiss these consequential factors. Regards, Dew