Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc. - 13 July 1996
Richard Jacobsen

Growing competition and a limited number of people able to pay for the drugs will keep their sales relatively modest, pharmaceutical industry analysts said.

The 11th International Conference on AIDS, which closed late Thursday, was highlighted by study results showing multi-drug "cocktails" with the new drugs -- known as protease inhibitors -- have driven HIV, the virus that causes AIDS, to undetectable levels in the blood of AIDS patients.

"The euphoria is more for beating the disease than a $1 billion or $2 billion drug coming out," said Steven Lisi, an analyst with Metha and Isaly.

Companies with recently marketed protease inhibitors -- Merck and Co. Inc., Abbott Laboratories Inc. and Roche Holding Ltd. -- all presented updated clinical trial results showing the drugs, in combination with older therapies, sharply cut levels of HIV.

The protease inhibitors and the older therapies, known as nucleoside analogues, work by blocking different enzymes that are key to HIV's replication.

On Thursday researchers said a combination of Abbott's protease inhibitor Norvir plus Glaxo-Wellcome Plc's AZT and 3TC left HIV virus undetectable in nine patients after up to about 43 weeks of treatment.

Merck said its Crixivan with AZT and 3TC, which is licensed from Biochem Pharma Inc., kept HIV at undetectable levels in the blood of six of seven patients after 48 weeks of a trial. Norvir and Roche's protease inhibitor Invirase were also shown to be effective when used together.

Scientists at the conference described the advances as a new chapter in the history of the battle against HIV.

"I believe there is truly an excitement in the clinical area that we haven't seen in some time," said Martin Schechter, co-chairman of the conference.

However, the researchers, along with industry analysts, were quick to note that the data were from a small pool of patients and from relatively short studies. A big question is for how long will the drug cocktails be effective.

"There's no euphoria" among investors, said independent analyst Hemant Shah. "I think people have more realistic expectations."

Competition is one factor tempering excitement, analysts said. Along with the three protease inhibitors on the market others are coming from other companies, including Agouron Pharmaceuticals Inc. and Vertex Pharmaceuticals Inc.

Lisi said he expected the drugs could have worldwide annual sales on average of about $400 million to $500 million each at their peak.

CJ Lawrence analyst Mariola Haggar was more conservative, however, saying she saw sales of Crixivan, which was approved by the U.S. Food and Drug Administration in March, at about $200 million a year by the year 2000.

"There's still a tremendous amount of scepticism in terms of how long this can continue," Haggar said of the positive trial data. If the drugs remain effective over longer periods, her sales estimates could prove to be low, she said.

AIDS is spreading fastest in underdeveloped countries in Asia and Africa, where most victims cannot afford the new drug regimes, which in the United States can cost around $15,000 a year.

"The market is growing rapidly, but people don't have any money to pay for the drugs," Shah said.

International health and development officials said at the conference that they were looking into ways of improving poor countries' access to the latest drugs.

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