RE:RE:RE:Couple of recent articles about TrogarzoI would argue the sales problems with Trogarzo had more to do with a very small trial that meant most doctors did not have a chance to have ownership in the drug's development and also the fact that a very small drug company with reduceed ability to access doctors versus big drug company sales reps, played a big role. For example, Fostemsavir had a much larger and longer trial and it is sold by a major drug company. According to Bloomberg, it reached the same level of dollar sales as Trogarzo in November, just six months into its launch and before all the insurance paperwork hassles are completely sorted out. And you have to assume that the average Viiv salesperson is not really even focusing on this relatively tiny product versus the other drugs they have to sell. I recently watched a video of doctors discussing MDR and their own slides seemed to indicate Trogarzo was a great option but it was the last slide in the presentation and Fostemsavir was discussed before it and more extensively even though it was clear Trogarzo had some advantages over it. It is not easy for small companies to find shelf space in the doctor's minds.
Price really should not be a factor due to insurance reimbursement and if doctors are choosing cheaper, less effective drugs for their patients, that is not good at all.
Clearly the IV is an issue that has had an impact though.
scarlet1967 wrote: Well of reasons we already know, not user friendly and expensive, having said that all viruses mutate eventually thus more cross resistance so as other ART drugs start failing the doctors/patients have no choice to use a superior treatment regardless of the cost and method of administration.
SPCEO1 wrote: The drug clearly works well. It is hard to fathom why it has not sold better than it has.
scarlet1967 wrote: "Background The principal goal of antiretroviral therapy (ART) is durable suppression of HIV RNA. In treatment-experienced (TE) patients, ongoing viremia can lead to further accumulation of drug resistance, increased morbidity and mortality. ART efficacy often depends on HIV disease severity; therefore, we sought to assess its impact on long-term virologic suppression in patients treated with Ibalizumab (IBA).
Conclusion In TE patients with advanced HIV disease, maximal viral suppression with IBA was observed regardless of BL CD4 or VL strata if patients remained on treatment. This demonstrates that TE patients across the spectrum of HIV disease, can achieve viral suppression by using drugs with a new mechanism of action." https://www.researchgate.net/publication/348173121_1008_Disease_Severity_Impact_on_Long-Term_Virologic_Response_to_Ibalizumab_in_Expanded_Access_Protocol_TMB-311
"Background Third line antiretroviral regimens have been associated with suboptimal virologic suppression, due to drug cross-resistance and regimen complexity. Yet, in treatment-experienced (TE) HIV patients, ART durability is essential for preventing further resistance and decreasing HIV-associated morbidity and mortality. Ibalizumab (IBA), the first long-acting, post-attachment inhibitor approved to treat multi-drug resistant (MDR) HIV, may support regimen durability given its directly observed administration.
Conclusion Data from 12 patients who received IBA for an average of 9 years validate the long-term efficacy and safety of IBA in TE patients. Importantly, for most patients, the durability of virologic response was maintained with minimal adjustments to the OBR. Altogether, these data demonstrate the contribution of IBA towards durable viral suppression in TE HIV patients with limited therapeutic options."
https://www.researchgate.net/publication/348173483_1027_Long-Term_Efficacy_Safety_and_Durability_of_Ibalizumab-Based_Regimens_in_Subgroup_of_TMB-202_Participants