AGilead has long been the leader in HIV treatments while GlaxoSmithKline trailed at its heels. However, Gilead’s lead might just be in danger now, as GSK CEO Andrew Witty announced that they are investing a lot to knock off one-third of the drugs most HIV patients are required to take.

A three-drug regimen has been the standard treatment for HIV since the mid-1990s, when doctors discovered that combining a new antiretroviral drug with two drugs from an earlier class could prevent the drug from developing resistance. GSK aimed to change that standard by working on an HIV drug that they dubbed would be a “game changer,” according to Wall Street Journal.

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GSK’s new treatment is based on dolutegravir (sold under the branded name Tivicay), a new powerful integrase inhibitor that arrests replication to rapidly reduce retrovirus levels in the blood. It is said to have the potential to change triple therapy into a dual one, considerably reducing patients’ medicinal expenses. By reducing the standard three-pill medication, it also reduces known side effects like nausea, diarrhea, kidney problems and bone thinning. More importantly, it also has the potential to be a monotherapy, albeit GSK remains cautious.

According to Dr. Rochelle Walensky at Harvard Medical School, it is estimated that a whopping €2.7 billion could be saved if just a quarter of the patients switched from triple therapy to dual therapy. This wouldn’t be hard to achieve, seeing as that what used to be just a pipe dream is now currently in clinical trials. It is combined with the antiretroviral 3TC (lamuvidine) or the NNRTI rilpivirine. Amazingly, there had been some positive preliminary findings and no resistance to it has yet been reported, but formal results are expected in 2017.

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GSK’s HIV/AIDS drug unit, ViiV Healthcare, which the company have Pfizer and Japan’s Shionogi as partners, recently struck a landmark deal in Botswana to provide the drug to as many people as possible in the African nation. It is part of a country-wide campaign to drum up the rate of HIV testing and treatment.

This breakthrough in the medicine industry made the future look good for GSK, but its main competitor Gilead is not going down without a fight. Their TAF-based triple therapies are effective at relatively low doses, mitigating kidney damage, and the company is developing its own integrase inhibitor due to be launched in 2018.

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