The price of antiviral drugs used for the treatment of HIV/AIDS is set to increase as more physicians embrace new, innovative combination medicines, a new report has found.

Researchers found that the cost of annual treatment for HIV/AIDS increased to an average of $12,829 in 2010 from $9,971 in 2002 and is set to continue to rise.

The report noted that the cost of treatment has increased steadily over the past decade after the launch of new combination therapies.

These new treatments are expensive but have demonstrated their worth through impressive efficacy, particularly in patients who have developed a resistance to standard options, and have become the treatment of choice for doctors.

As a result, revenue from the global HIV/AIDS market grew at a compound average growth rate of 10.9% from 2002 to 2010.

This year a number of key brands used in the treatment of HIV/AIDS will lose patent protection. Sustiva and Combivir will go off patent in 2012 after Epivir, Epzicom, Trizivir, Ziagen, Invirase and Lexiva lost protection in either 2010 or 2009.

Whilst generic alternatives have now been made available, it is the use of these combination medications which has seen the market continue to grow.

The market is also expanding, the report found, due to decreasing mortality and increasing treatment-seeking rates, which has encouraged further pharmaceutical innovation.

This innovation has been highlighted with the release of Gilead’s new Quad treatment and late-stage pipeline products including Edurant and Vicriviroc.

A new once-daily single tablet for initial treatment of HIV infection, making combination drug therapy simpler, has been approved for marketing in the EU.

Eviplera, supplied by Gilead Sciences in collaboration with Tibotec Pharmaceuticals, has been approved by the European Commission as a first antiretroviral in adults whose viral load is below 100,000 HIV-1 RNA copies/ml.

The new drug combines Gilead’s Truvada, a fixed-dose combination of the reverse transcriptase inhibitors emtricitabine and tenofovir disoproxil, with Tibotec’s rilpivirine (sold by Janssen-Cilag as Edurant).

“As people with HIV are living and remaining on treatment longer, the availability of new simplified therapeutic options has become even more critical,” said Dr. Mark Nelson, Service Director for the HIV Directorate, Chelsea and Westminster Hospital, London, United Kingdom.

"Eviplera has the potential to be an important new treatment option for patients starting HIV therapy because it streamlines an effective HIV treatment regimen into a single daily tablet.”

John C. Martin, Chairman and CEO of Gilead Sciences, commented: "Gilead continues to lead the development of single-tablet regimens because we and our partners recognize the ongoing need to simplify HIV therapy. With Eviplera, we are now working with national authorities to ensure the regimen is made available across the EU as quickly as possible.”

Eviplera is the second single-tablet HIV treatment to gain marketing approval in the EU. The first, Atripla, was launched in in 2007 by Gilead in partnership with Bristol-Myers Squibb and MSD.

The authorisation of Eviplera was supported by phase III clinical trials carried out by Tibotec that demonstrated the efficacy and safety of rilpivirine in treatment-naïve HIV-infected adults, and a bioequivalence study carried out by Gilead which showed the single tablet to achieve the same levels of medication in the blood as the three drugs administered separately.

Gilead will lead the manufacturing and commercialisation of Eviplera in the EU, the US, Canada, Brazil, Australia and New Zealand, while Tibotec will be responsible for commercialising rilpivirine as a single agent and can co-detail the single-tablet regimen in these territories.

Tibotec will commercialise the product in Africa, the Middle East, Eastern Europe and Japan.

The FDA has approved a once-per-day combined pill by Gilead and Johnson & Johnson for the treatment of HIV in the US.

Complera has been approved as a first-line treatment for patients who have not been previously treated for HIV.

The pill combines Gilead’s drug Truvada (emtracitabine and tenofovir) and Johnson & Johnson’s Edurant (rilpivirine).

Both drugs are already approved as part of a drug cocktail or combination HIV therapy, but the combined pill is now approved as a stand-alone regimen.

Further manufacturing, development and marketing are set to be headed by Gilead in the EU, Canada, Brazil, Australia and New Zealand.

Complera is the second once-per-day drug intended for untreated HIV, approved in 2006. The first was Atripla, which is marketed by Gilead and Bristol-Myers Squibb.