Sales of the antiretroviral drug Fuzeon, which attracted worldwide attention earlier this year, have been slower than expected, the Raleigh News & Observer reports. The drug has "ru[n] into resistance" from doctors and patients because of its high cost and injection delivery method (Vollmer, Raleigh News & Observer, 9/16). The FDA in March approved Fuzeon, which is designed for HIV/AIDS patients who have failed to respond to other medications. The drug, developed by pharmaceutical companies Roche and Trimeris, costs about $20,000 per patient per year, double the price of the most expensive HIV treatments currently on the market. Fuzeon is in a new class of drugs called fusion inhibitors, which prevent HIV from entering cells by preventing the virus from attaching to cell membranes (Kaiser Daily HIV/AIDS Report, 8/25). Shares of Trimeris "tumbled" yesterday after the brokerage firm SG Cowen said that Fuzeon's slow sales would delay the company's profitability by two years, according to Dow Jones/AP. "Unlike the current oral HIV agents, Fuzeon requires multiple steps to prepare and reconstitute for injection," SG Cowen analyst Yaron Werber wrote in a research note, adding, "Additionally, pain and unattractive nodules stemming from injection site reactions are deterrents" (Dow Jones/AP, 9/16).

Supply and Demand
Werber wrote that physicians now estimate that only 10% of HIV-positive patients will be candidates for Fuzeon, whereas doctors originally believed that 27% of patients would be possible candidates, according to the News & Observer. When the drug was approved, some analysts speculated that the company would be unable to make enough of the drug to meet demand, the News & Observer reports. However, analysts now say that demand, not supply, is hampering the drug's sales. In addition, some states are "cautious" about including Fuzeon under Medicaid coverage because of the drug's high cost. California currently requires doctors to gain prior authorization before prescribing the drug, according to AIDS Healthcare Foundation President Michael Weinstein. To help lift sales, Trimeris may target nurses to educate patients about injecting themselves and may look into auto-injection devices and multidose vials, company spokesperson Robin Fastenau said. An effective oral version of Fuzeon "is years from becoming a reality," Fastenau said, according to the News & Observer. Fuzeon loses its effectiveness when taken orally in its current formula (Raleigh News & Observer, 9/16).

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