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Well, PrEP is a miracle drug that has gone criminally underutilized in the fight to eradicate HIV. It would be nice to see governments really push it hard for a
by jimbob45 7y ago
Well, PrEP is a miracle drug that has gone criminally underutilized in the fight to eradicate HIV. It would be nice to see governments really push it hard for a change.
- mm202018 7y agoIt’s insane that it is $1400/month out of pocket, and if you have a high deductible plan you’d still be paying $6k+ potentially before it’s covered.
- sjaknanxnnx 7y agoMy friend who’s on a high-deductible plan says they reimburse you for the portion that’s before your deductible. It’s actually kind of a sweet deal because you hit your deductible without being out any money. Then you don’t have to worry about paying for medical care for the rest of the year.
- mm202018 7y agoWho is “they”? There’s a copay card you can use from Gilead that helps pay your co-pay but not aware if that helps you hit out of pocket expenses before you hit your deductible or if that counts as your copay.
- sjaknanxnnx 7y agoThe way it was explained to me is: you use the Gilead card to pay you copay, and that counts toward your deductible. So, my last post was wrong to use the word “reimburse”.
- homero 7y agoI use a different medication where i pay the copay on a credit card and they rebate me a check
- ingenium 7y agoIt depends on your insurance, but on some it will.
- jlangenauer 7y agoWHAT!? Here in Germany, my PrEP costs me €40 per month, and I only have to pay that because it’s one of the rare things that insurance doesn’t cover here.
- tomlockwood 7y agoIn Australia its around $40 a month, so slightly less. Worth it!!! Still, too expensive for some people. Should be free.
- pasquinelli 7y agoI wonder why it's so much more expensive in the united states.
- trophycase 7y agoDon't ask lol
- galangalalgol 7y agoyeah, shocking. if you have diabetes or a thyroid issue or hiv or really any chronic disease that requires medication you are out 12k a year easy, 6 for your insurance premiums and 6 for the deductible and copays. if you are broke there are some provisions, but if you are above the poverty line you gotta pay.
- vinni2 7y agoIs this true for health insurances paid by the employers too? I am just curious since people say if you have a tech job you have nothing to worry about healthcare in the US.
- gnopgnip 7y agoIn many cases the premium is paid for by your employer entirely, and the max out of pocket is lower, like $4k a year. But it depends on the employer and what plans afte offered. Also about 20% of Americans are on medicaid, and generally do not pay any premiums, deductibles, or copays
- wjnc 7y agoI've checked and it's € 50 a month in the Netherlands for the pills. There is something else going on with that pricing. There are doctor fees on top of that, but a few checks a year will never consitute the $15k difference.
- dillondoyle 7y agoI can confirm in the US it is truly that expensive (which is fucking crazy). I have pretty good insurance (or at least the best I can get self-buying) but I still have to pay 30% of meds costs. That is something like $400 /month. Luckily Gilled will reimburse up to 7500 /year. Fucked up private insurance in US, they charge that much and then do the reimbursement so they can bill the huge monthly cost to plans / government that will cover it. We should be giving this out for free. My MD said Truvada might go generic next year, so perhaps there's hope.
- malandrew 7y agoIn the US, we’re paying obscene prices because no other country pays their fair share to recoup the cost of development plus bringing the drug to market plus a reasonable margin for the effort. The US should establish an agreement whereby US patients pay a LOT less but that the foreign patients need to pay the same. The amount the industry earns should be low enough to make it reasonably financially accessible to patients but high enough to prompt our best and our brightest to pursue new drug development as a career.
- ben_w 7y agoPricing is always and inevitably what the market can bear, not anything about “fairness”. If prices are too high or communities are too poor (communities not countries), those communities go without. Right now, the US is so expensive that in cases like this it makes sense for patients to fly to another country to get the medicine. That’s unsustainable.
- Nasrudith 7y ago
- wsc981 7y agoPerhaps more countries should follow Thailand's approach: On January 25, 2007, Thailand’s interim government issued compulsory licenses–which require manufacturers to license generic versions of their patented drugs–for two Western medicines: Kaletra, an advanced anti-AIDS medicine manufactured by Abbott; and Plavix, a blood-thinning treatment to help prevent heart disease, produced by the France-based Sanofi-Aventis and U.S. firm Bristol-Myers Squibb. These attacks were preceded in November 2006 by a violation of Merck’s patent on the anti-AIDS drug Stocrin.[5] The government threatened to break patents on eleven more drugs.[6] Explaining the rationale behind Thailand’s decision, health minister Mongkol Na Songkhla said that “the move is permissible under international trade rules in the event of national public health emergencies. . . . We have to do this because we don’t have enough money to buy safe and necessary drugs for the people under the government’s universal health scheme.”[7] Source: http://www.aei.org/publication/thailand-and-the-drug-patent-wars/ http://www.aei.org/publication/thailand-and-the-drug-patent-... Perhaps "evergreening" is also an issue in the USA that might keep prices high for a long time? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680578/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680578/
- andy_ppp 7y agoQuoting like this makes it impossible to read on mobile. Not your fault but “speech marks” are fine.
- WillDaSilva 7y agoAre you using an app such as Materialistic or Hews, or just using your browser? For what it's worth I don't recall any problems reading quote blocks on Materialistic.
- rabbitonrails 7y agoLike most people, I am reading on a mobile browser and cannot read this quote.
- bobwaycott 7y ago
- rukugu 7y agoThat's insane. In Kenya, PrEP is offered free of charge in all public hospitals while in private hospitals, brand name drugs will set you back about $35, while generic equivalents cost about $4.
- vinni2 7y agoIt is insane! In Norway it is absolutely free!!
- ChrisRR 7y agoThat's insane. In the UK the NHS doesn't supply it yet, and GPs won't officially recommend it. But you'll find the NHS clinics quite often recommending prep purchase through international websites and referring you to HIV charities. It costs about £30 pm in that case which is about $40 Often they'll be running studies at the same time to assess the feasibility of Prep on the NHS.
- tapland 7y agoSweden just added it like 2 weeks ago. More to come hopefully.
- jdietrich 7y agoPrEP is now available on the NHS in Scotland and on a pilot basis in England, Wales and Northern Ireland. https://www.iwantprepnow.co.uk/prep-on-the-nhs/ https://www.iwantprepnow.co.uk/prep-on-the-nhs/
- ChrisRR 7y agoThanks for the info
- devoply 7y agoI think that's not the case in Cuba which heavily subsidized and dosed its population hence the high rates of resistance.
- Aloha 7y agoPrEP is hard to get, my doctor outright refused to prescribe it to me, they said they were not comfortable doing so
- rickycook 7y agothen get a new doctor. there is no medical rationale behind this, and they are letting irrational personal feelings get in the way of your good health
- Geimfari 7y agoNo that's not the case, the side effects of PrEP aren't minor. PrEP should not be prescribed so lightly.
- matthewmacleod 7y agoYes, that is the case. Tenofovir and emtricitabine are generally well-tolorated. They can affect bone density and kidney function and this should be monitored; the majority of people experience no side-effects.
- magic_beans 7y agoIf you have the time to browse HN, you have the time to browser your health insurance website for a new doctor!
- kgwxd 7y agoDid they give a reason for their discomfort?
- Aloha 7y agoLack of familiarity with the drugs mostly.
- jlangenauer 7y agoThe get a new doctor, one who values your health more than their antiquated morals.
- deleted 7y ago[deleted]
- dschuetz 7y agoHow do you know if PrEP also works in the high-resistance cases?
- lm28469 7y agoMiracle drug with unknown long term side effects* I wouldn't take it unless I was a non monogamous gay man[0], the risks out-weights the benefits in any other demographics imho. [0] not that I have anything against that per say, it's just statistically the most affected demographic
- nness 7y agoI don't follow your comment; The drug is intended for those people at risk of contracting the disease. Why would you take PrEP if you weren't at risk? (Your also discounting drug users; but unfortunately those addicted and at risk are also the least likely to have the means to acquire the drug.)
- lm28469 7y agoNot a day goes by without an article mentioning it in mainstream medias. They rarely mention the target in these articles.
- notyourday 7y agoIt is not about who the drug is being intended for -- it is about who the drug is being marketed to. For example there's a massive campaign targeting both men and women engaging in any sort of sexual activity that includes fluid exchange promoting usage of PrEP. One can see it in a subway and on local commercials on TV.
- joshuamorton 7y agoWhere?
- notyourday 7y agoNYC.
- nness 7y agoAssuming in the US? (can't think of another market where prescription drug marketing is unrestricted)
- nness 7y agoIn many countries it's easy and relatively cheap the get. It's horrible it's only available with insurance and high costs in the US. For those curious; in Australia, it's prescribed and costs about $50-60 p/month. In the UK, it varies; England and Wales are doing trails, and Scotland it's prescribed. Under the NHS, it's £9. In Canada, the generics cost upward of $300 per month. (https://www.prepwatch.org/ https://www.prepwatch.org/)
- quotemstr 7y agoUnless PrEP succeeds in eradicating HIV (which might be possible if enough people are on it to limit the spread of the virus), it seems tailor-made to breed resistance. We don't generally give antibiotics prophylactically. Using anti-retrovirals this way seems like a bad idea from a drug resistance perspective.
- blablabla123 7y agoI wonder if that's true though. I don't have a medicine background but I'm loosely following this development. I think the term drug resistance became popular with all these tuberculosis cases. What happened was that people got TB, they went to the doctor and got medicine. Then things got better and people felt healthy again so they stopped taking their medicine. BUT in reality they were supposed to take it for a longer period of time and then TB broke out again. And thus becoming drug resistant. https://www.who.int/tb/areas-of-work/drug-resistant-tb/xdr-tb-faq/en/ https://www.who.int/tb/areas-of-work/drug-resistant-tb/xdr-t...
- quotemstr 7y agoRight. For resistance to evolve, some part of the treated population must survive. (You can't evolve resistance to atomic weapons dropped on your head.) Is PReP really effective enough to ensure that there are no survivors? Sure, maybe it is, used correctly at therapeutic doses. What if it becomes common enough to get into the water at much lower doses? What if people split pills to reduce costs? ISTM that there are many potential avenues for evolving resistance.
- ShlomoS 7y ago>Is PReP really effective enough to ensure that there are no survivors? No, the first bug chaser to successfully contract HIV while on it was quite proud of his achievement. Clearly the virus can survive.
- ls612 7y agoHIV is sexually transmitted. It can’t survive in the water or the air. So the presence of anti HIV drugs in the environment shouldn’t have an impact.
- Geimfari 7y agoThe drug has several non-minor side effects, is prohibitively expensive, and is the same as the treatment for someone who already has the virus. I for one think it's improper to prescribe a drug with these nephrological side effects to a large number of otherwise healthy individuals, not even accounting for the cost.
- deleted 7y ago[deleted]
- agentdrtran 7y agoWhere did you go to med school?
- hcurtiss 7y agoWhat a snide reply. Is it necessary to be a doctor to have an opinion on healthcare policy?
- deleted 7y ago[deleted]
- jfengel 7y agoThey were speaking of medicine rather than policy, and getting it wrong. PReP is not the same course as treatment, and prophylaxis is always a thing given to healthy people rather than sick ones. The side effects are considered manageable: you watch for signs of liver problems and you don't give the drug to people prone to them. I'm not a doctor but I can read the prescribing information[1], which they don't seem to have done. [1] https://web.archive.org/web/20161221124917/http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021752s047lbl.pdf https://web.archive.org/web/20161221124917/http://www.access...
- hcurtiss 7y agoArguing the facts is totally good. And you may very well be right (I don't know anything about the subject). But attacking the commenter's position because he/she is not a doctor (like you are not a doctor), struck me as poor form.