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HIV markets show promise in India and Brazil

Growth opportunities exist for 'Big pharma' as concerns over resistance and intolerance are leading to greater pressure on governments in India and Brazil to increase funding for newer antiretroviral treatments for HIV.

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Independent market analyst Datamonitor believes that the best strategy for international drug makers to penetrate the Indian and Brazilian market is through voluntary licenses and agreements with domestic manufacturers.

Mansi Shah, Datamonitor senior healthcare analyst, comments: “Lifelong therapy is required for the management of human immunodeficiency virus (HIV) infection. This has helped antiretroviral drugs become an important revenue driver in the major western markets for several of the leading Big Pharma companies. However, limited growth opportunities in established markets have focused attention on the unmet need and high disease burden of emerging markets such as India and Brazil.”

Issues in both countries have so far limited their attractiveness as a target market for external HIV drug developers.

Shah explains: “To maintain universal access to HIV antiretrovirals, the Brazilian government is pursuing controversial strategies. One such example is the use of compulsory licensing to secure antiretroviral drugs for the domestic market at lower prices. At the same time in India, treatment focuses on generic first-generation antiretrovirals, resulting in a strong dominance of domestic generics manufacturers such as Cipla or Emcure.”

As the number of patients accessing therapy in both these markets rises, issues such as resistance and intolerance will increase the need for novel second- and third-line therapies.

One result is that the Brazilian government has recently increased its spending on new and more expensive agents. This represents significant opportunities for companies marketing novel antiretrovirals.

In India, the 2005 Patent Act may lead to improvements in intellectual property protection for global companies. Patents for Selzentry (maraviroc), Isentress (raltegravir) and Intelence (etravirine) have recently been granted, although those for Viread (tenofovir) and Prezista (darunavir) have been rejected.
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