HIV: Prescription barriers costing drugs market share in US, EU5. Can the #1 brand keep its lead?

Market barriers affect almost 20 percent of HIV prescriptions in both the US and Europe, causing major brands to lose, and sometimes gain market share. This is according to a new series of reports from FirstWord that explores how barriers affect eight commonly prescribed HIV treatments — Evotaz, Intelence, Isentress, Selzentry/Celsentri, Stribild, Triumeq, Truvada and Viread.

Barriers are factors other than safety and efficacy (e.g., cost and reimbursement, labelling restrictions, patient preferences, etc.) that prevent doctors from prescribing the drugs they want. But when doctors can't prescribe one drug, they prescribe a competing brand. That has helped three brands in the US, and four in Europe, increase their overall market share.

Essential competitive information for brand owners

Based on surveys of 100 US, and 150 European infectious disease specialists, FirstWord's reports explore the dynamics between the eight covered brands, showing readers how each one wins market share from, and loses it to, the other seven, and revealing which barriers drive each brand's gains and losses.

In the crowded HIV treatment market, where doctors tend to switch brands frequently to keep patients from building up resistance, that kind of information can help brand owners better focus their marketing efforts. This is especially true for companies with multiple brands in the HIV treatment area (e.g., Gilead Sciences, ViiV Healthcare), who must position their products carefully to manage perception among doctors and patients.

Highly active market

Both the US and EU5 reports paint a picture of a competitive market where companies are doing a good job of managing market access. Brand awareness is high and nearly all surveyed products are widely prescribed. And while the top-ranking brands are fixed-dose combinations, monotherapies also feature prominently in each region's top four. Market barriers affect less than 20 percent of prescriptions in either region, and few doctors report experiencing more than one barrier for any given brand.

Clear winners & losers

Nevertheless, each market sees clear winners and losers. In both the US and EU5, one brand is well ahead of the pack. The leading brands enjoy the highest market share, and tend to see the biggest barrier-related share gains. Conversely, less-prescribed brands tend to have smaller share and bigger barrier-related losses (although interestingly, the product with the biggest losses in the US is a top-4 brand with the third largest market share).

Top concerns differ by region

When it comes to the barriers that have the biggest impact on prescribing, market-access issues such as cost and formulary availability are the top concerns in the US market. Cost is a concern in Europe too, but in the EU5 countries, labelling issues such as guideline- and patient-type restrictions affect more prescription decisions.

Effects vary by brand

One of the report's key findings is that the "barrier effect" doesn't apply to all brands equally. In fact, the number of doctors who report experiencing the biggest market barriers can vary as much as 20 percent from one brand to the next. This kind of data hints at why certain brands are losing share to competitors. For example, niche products may be losing out because doctors are bumping up against patient-type restrictions, while more expensive treatments may simply be losing out to cheaper alternatives.

Reports Now Available

Get all the details in FirstWord’s FirstView Market Access Impact: HIV reports for the US and EU5 markets, now available from the FirstWord web site.

Sample pages are available on request.

For more information, contact FirstView ( or call +1 212-220-0880 or +44(0)20.7665.9240

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