Global healthcare company GlaxoSmithKline
As of the 1990's, modern medical treatments have rendered the HIV virus more "chronic condition" than life sentence. This was due to the rise of drastically improved medical therapy reliant upon a combination of a revolutionary new antiretroviral drug with two previously established drugs. Taken together, the three drugs was more effective in preventing the HIV virus from gaining resistance, making the illness much more manageable for patients. Since then, the three-drug combination has been the standard.
Rather than innovating away from this tried-and-tested procedure, pharmaceutical and research companies have focused on maximizing potency and effectiveness for various three-drug combinations. But now, Glaxo is intending to introduce a new paradigm: an HIV pill that promises to function when combined with one other drug, not two. Glaxo CEO Andrew Witty hopes this choice will be a tremendous leap for the medical industry and HIV treatment and theory. Patients, too, have much to gain, as fewer drugs means fewer side-effects.
Glaxo's new drug is called dolutegravir--a member of the class of integrase inhibiting drugs used in HIV treatment. Integrase inhibitors reduce the amount of virus in patients' bloodstreams, and has previously been approved for use in triple-therapy treatment models. As of late August 2016, there have been no known cases of new HIV patients developing resistance to dolutegravir. This is a promising sign, which renders dolutegravir unique amongst all integrase inhibitors. Glaxo's new initiative is directed by the Glaxo-owned ViiV Healthcare--for which Pfizer Inc. [NYSE: PFE] and Shionogi & Co [TYO: 4507] act as minority stakeholders.
Despite findings which suggest that dolutegravir is capable of suppressing HIV on its own, there are dangerous risks associated with marketing the drug accordingly. In response, Glaxo has prudently chosen to take a "precautionary stepwise approach to investigating its promise," according to a Glaxo spokeswoman quoted in a Wall Street Journal article.
Side-effects from traditional HIV triple-drug cocktails included "nausea, diarrhea, kidney problems and bone thinning," according to The Wall Street Journal article. Since two-drug cocktails would greatly minimize the number of side-effects, there are many incentives for reducing the number of drugs involved. Fewer drugs also means fewer prescriptions--thus lessening the overall cost of treatment for patients. On the national scale, the gains are even greater: one estimate figures that switching a quarter of all HIV patients to the two-drug method would result in over a 3 billion dollars in savings from HIV treatment costs in five years.
So far, Glaxo's drug research trials have all yielded positive results. However, the company might face a problem with "inertia," due to a timing overlap between dolutegravir's entrance on the market and TAF, a new drug from Glaxo's rival Gilead
Glaxo and Gilead are two competitors which both enjoy strong positions in the HIV treatment market. However, should Glaxo's dual-therapy methods fail and Gilead's integrase inhibitor succeed, Glaxo's market share gained through dolutegravir will be reclaimed by Gilead. In this case, Glaxo's business would be expected to decline after 2018, which is the year that Gilead plans to release its integrase inhibitor.
Despite these predictions, Glaxo leaders are optimistic. They claim that the window of time required for Gilead to finalize its drug will be sufficient for dolutegravir to become better-established (and hence more popular) in the market for HIV treatment.
