ABOUT DATAMONITOR HEALTHCARE 2
About the Infectious Diseases pharmaceutical analysis team 2

CHAPTER 1 EXECUTIVE SUMMARY 3
Strategic scoping and focus 3
Datamonitor insight into the disease market 3
Related reports 5
Upcoming related reports 5

CHAPTER 2 MARKET DEFINITION AND OVERVIEW 7
Market definition for this report 7
Countries and regions included in this report 7
Seven major market assessment 9
Current and future market overview 9
The US will remain the largest HIV market 11
Early initiation of therapy to contribute to market growth 13
Dynamics of first-line therapy to change but cross-class fixed dose combinations will dominate 15
NRTI sales to decline over the next decade but Truvada will continue to grow 17
Comparison with previous forecast 17
Both forecasts display an overall growth in the HIV market driven by new product launches 18
Truvada maintains a steady growth in updated forecasts 19
Additional pipeline drugs 19
Rest of the world snapshot 20
Rest of the world sales accounted for 13% of global total antiretroviral sales 20
Outside the seven major markets the Canadian market remains the largest 21
Branded drugs are less popular in Rest of the World due to the availability of PEPFAR combinations 23

CHAPTER 3 BRAND DYNAMICS 24
Overview of competitive landscape 24
The top 10 brands accounted for 80% of total antiretroviral sales in 2008 24
Atripla will surpass Truvada in 2009 27
Reyataz displaces Kaletra as leading protease inhibitor 27
Despite being the fifth best selling antiretroviral, Epzicom sales lag behind Truvada 28
Marketed drugs 29
Atripla (tenofovir disoproxil/emtricitabine/efavirenz; Gilead Sciences/Bristol Myers Squibb) 29
Atripla's dominance threatened by drugs offering better tolerability 29
Sustiva patent expiry to shift market share back to Truvada 30
Updated forecasts reflect the impact of the Quad Pill and Sustiva patent expiry on Atripla sales 31
Reyataz (atazanavir; Bristol Myers Squibb) 32
Reyataz is the new protease inhibitor class leader 32
Reyataz being studied as part of a nucleoside sparing strategy 32
No significant changes in new Reyataz forecasts 33
Prezista (darunavir; Tibotec/Johnson & Johnson) 34
ARTEMIS results win first-line approval for Prezista 35
Isentress (raltegravir; Merck & Co) 36
48-week STARTMRK data confirm efficacy in treatment-naïve patients 37
Isentress is being investigated in nucleoside sparing regimens 38
SWITCHMRK fails to demonstrate the benefit of switching to Isentress in fully suppressed patients 39
Updated Isentress forecasts reflect the impact of the Quad Pill 40
Pipeline drugs 41
Quad pill (tenofovir disoproxil/emtricitabine/ elvitegravir/GS 9350; Gilead Sciences) 41
Elvitegravir alone is unlikely to make a significant impact on the HIV market 41
Phase II study investigates Quad Pill in naïve patients against Atripla 42
Atripla and Truvada to lose significant share to Quad Pill 43
Rilpivirine (TMC278; Tibotec/Johnson & Johnson) 44
Phase III studies investigate rilpivirine in naïve patients 45
Rilpivirine has potential to replace Sustiva but Atripla's convenience will be tough to compete with 45
Updated rilpivirine forecasts are similar to the previous forecasts 46
BIBLIOGRAPHY 48
Websites 48
Others 48
Datamonitor reports 50

APPENDIX A - MARKET ASSUMPTIONS 51
Data definitions, limitations and assumptions 51
Standard units 51
Japanese market data 52
Derivation of sales forecasts and pricing trends 52
Forecast methodology 52

APPENDIX B 53
Contributing experts 53
Conferences attended 53
Report methodology 53
About Datamonitor 54
About Datamonitor Healthcare 54
About the Infectious Diseases analysis team 55
Disclaimer 56

List of Tables
Table 1: Comparison of leading branded drug sales ($m) for human immunodeficiency virus (HIV) in the seven major markets and the Rest of the World (ROW), 2008 23
Table 2: Leading branded drug sales ($m) for human immunodeficiency virus (HIV) in the seven major markets, 2008-2018 24
Table 3: Key products in late-stage R&D pipeline for the treatment of human immunodeficiency virus (HIV), 2009 25
Table 4: Datamonitor's estimated launch dates for human immunodeficiency virus (HIV) products in the seven major markets, 2008-2017 51

List of Figures
Figure 1: Antiretroviral sales ($m) in human immunodeficiency virus (HIV) by type of product (marketed versus pipeline) in the seven major markets, 2004-2018 10
Figure 2: Branded antiretroviral sales ($m) by drug class in the seven major markets, 2004-2018 11
Figure 3: Human immunodeficiency virus (HIV) market share by region, 2008-2018 12
Figure 4: Estimated number of people living with human immunodeficiency virus (HIV) in the US, 5EU and Japan, 1997-2007 13
Figure 5: Comparison of Datamonitor's 2008 and updated sales ($m) antiretroviral forecasts in human immunodeficiency virus (HIV) for the seven major markets, 2007-2018 18
Figure 6: Rest of the World versus seven major market sales ($m) split for antiretrovirals in the human immunodeficiency virus (HIV) market, 2008 20
Figure 7: Number of people receiving antiretroviral drugs for human immunodeficiency virus (HIV) infection in low- and middle-income countries, 2002−07 21
Figure 8: Annual global sales of antiretrovirals in the human immunodeficiency virus (HIV) market, 2004-08 22
Figure 9: Market share of leading brands in 2008 and 2018 across the seven major markets 26
Figure 10: Datamonitor's 2008 and updated sales ($m) forecast for Atripla in human immunodeficiency virus (HIV) across the seven major markets, 2008-2018 31
Figure 11: Datamonitor's 2008 and updated sales ($m) forecast for Reyataz in human immunodeficiency virus (HIV) across the seven major markets, 2008-2018 34
Figure 12: Datamonitor's 2008 and updated sales ($m) forecast for Prezista in human immunodeficiency virus (HIV) across the seven major markets, 2008-2018 36
Figure 13: Datamonitor's 2008 and updated sales ($m) forecast for Isentress in human immunodeficiency virus (HIV) across the seven major markets, 2008-2018 40
Figure 14: Datamonitor's sales ($m) forecast for elvitegravir in human immunodeficiency virus (HIV) across the seven major markets, 2008-2018 42
Figure 15: Datamonitor's sales ($m) forecast for Quad Pill in human immunodeficiency virus (HIV) across the seven major markets, 2008-2018 44
Figure 16: Datamonitor's sales ($m) forecast for rilpivirine in human immunodeficiency virus (HIV) across the seven major markets, 2008-2018 47