Vaccines and bone marrow transplants could severely crimp the $12-billion-a-year AIDS drug market currently dominated by Gilead Sciences (Nasdaq:GILD), Pfizer (NYSE:PFE), GlaxoSmithKline (NYSE:GSK), Merck (NYSE:MRK) and Abbott (NYSE:ABT).
It’s been three decades since the first case of AIDS was reported. But thanks to better diagnostic tests and the antiretroviral drugs provided by these members of the pharmaceutical industry an AIDS diagnosis is no longer a death sentence. AIDS patients are now living for decades. In fact, it’s estimated that more than 30 million people around the world are doing just that, living with HIV, the virus that causes AIDS.
The problem is far from being solved, however. AIDS drugs take a heavy toll on the patient, causing serious side effects, including diarrhea, nausea, vomiting and weight loss. Those on the drug can also become depressed. What’s more, the virus can build resistance to the drugs if the patient misses doses.
And then there’s the cost issue. The drugs are so expensive that the majority of the world’s infected population can’t afford treatment, which can range from around $150 a year in poor countries, where cheap generics are available, to more than $20,000 a year in the U.S.
A recent study suggests that low and middle-income countries will need $35 billion a year to properly address the AIDS pandemic by 2031. That’s almost three times the current level of around $13 billion a year. Add in the costs of treatment in rich countries and experts estimate the costs of HIV 20 years from now will reach $50 billion to $60 billion a year.
Vaccines could be a cheaper alternative to drugs, specifically the generation known as “mosaics.” They are composed of many sets of synthetic, computer-generated sequences of proteins that can prompt the immune system to respond to a variety of strains. The trial that has generated the most promise to date was conducted in Thailand, with the results released in 2009. They showed that those who received the vaccine, made by a division of Sanofi-Aventis (NYSE:SNY), saw a 31% percent drop in HIV infection compared to those who received placebo.
Encouraged by the results of the Thai trial, Dutch biotechnology company Crucell, which Johnson & Johnson (NYSE: JNJ) acquired earlier this year for about $2.3 billion, is collaborating with a number of prestigious researchers on what’s being called a “prime-boost” combination vaccine. If the Phase I trial is successful Crucell says they will pursue plans to mount a proof-of-concept Phase IIb study.
Using bone marrow transplants to great AIDS patients is probably quite a bit further off. But the technique has shown promise. In Germany, scientists used cells from a donor with a rare genetic mutation that has proven resistant to HIV to treat an AIDS patient. That patient survived, becoming the only know human to actually be cured of AIDS. Even though it would be impractical and costly to cure large numbers of AIDS patients with transplants, scientists are encouraged that at the very least they proved it could be done.
