title: Antiretroviral drug development: the challenge of cost and access.
abstract: The global threat of HIV infection requires sustainable solutions driven by investments from both the public and the private sector. The pharmaceutical industry has supported research and development of antiretroviral therapies that have prolonged the lives of individuals infected with HIV. The medical need for new antiretroviral agents remains great, however, a consequence of the progressive evolution of viral resistance. In order to meet this ongoing challenge, investment into research and development needs to continue. These investment decisions are made relative to other pressing healthcare concerns and are based on assessments of the likelihood of technical success, the ability to define the clinical value of any new medicine, the patient's perception of medical need, and the ability of society to support the patient's access to those medicines. Any new antiretroviral therapy must be anticipated not only to work against future resistant strains but to work well with other agents as part of combination therapies. Those challenges are coupled with the need for systems that optimize patients' access to treatment, including the global regulatory process, reliable and quality manufacturing and distribution systems, and basic healthcare delivery infrastructure. Synergies generated from the contributions to HIV care by both the public and private sector will, in the long and the short run, lead to improvements in the health and well-being of individuals living with HIV.
authors.affiliation: Pfizer Global Research and Development, 50 Pequot Avenue, New London, CT 06320, USA. michael.w.dunne@pfizer.com
authors.forename: Michael
authors.initials: M
authors.lastname: Dunne
mesh_terms: D019380:Anti-HIV Agents / Q000737:chemistry / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics; D002626:Chemistry, Pharmaceutical; D002648:Child; D016527:Drug Costs; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans
chemical_list: D019380:Anti-HIV Agents