11 ms·
Interested to hear from people in the know: how good does this look?
by dj_mc_merlin 6y ago
Interested to hear from people in the know: how good does this look?
- dheera 6y agoInterested to hear the same. In particular, how easy will distribution be, considering that HIV is extremely easily preventable but it still spreads, because of lack of distribution of knowledge, I assume.
- taurath 6y agoCost is the largest factor. HIV could be nearly eliminated entirely if PREP wasn’t a cash cow for Gilead.
- fny 6y agoUhm... Last I checked many pharmaceuticals that compete with Gilead also operate in the HIV space.
- heavyset_go 6y agoNo, the only two drugs approved for PrEP in the US are Truvada and Descovy, both of which are Gilead drugs.
- fny 6y agoI stand by what I said. On a worldwide revenue basis, there are many other manufacturers that have strong incentives to develop a cure. Also, I disagree that "PrEP" would eliminate HIV. It's a prophylactic, not a cure, and one that will not be affordable globally for a looooong time. Even at $30 per month, the drug would be out of reach for many (see Africa where annual incomes hover around $1-2K annually.) 1. Gilead owns 3 of 4 top HIV drugs. GSK owns the #2, Triumeq. 2. GSK, Merk, J&J are all megacap, viable competitors with their own HIV products. Yes, its true that Merk and Gilead are in cahoots, but this was out of fear of GSKs dominance. 3. Some other US-listed names who are developing HIV drugs: ViiV (GSK subsidiary), Bristol Myers Squibb, Janssen, Mylan, Genentech, Abbvie. Yes, the US is currently dominated by one company, but that does not mean there are heavy incentives for competitors--who are already well invested in the space--to break in. [0]: https://www.statista.com/statistics/273434/revenue-of-the-worlds-most-important-aids-drugs/ https://www.statista.com/statistics/273434/revenue-of-the-wo...
- taurath 6y agoI stand by my assertion that cost is the limiting factor :)
- deleted 6y ago[deleted]
- tjohns 6y agoGilead's patent on Truvada (the most common drug used for PrEP) just expired. As of a few months ago it's available as a generic.
- heavyset_go 6y agoGeneric Truvada costs between $1600 - $2200 a month without a discount. GoodRx brings it down to about $600 - $1200.
- tjohns 6y agoAs I understand it, only one company makes the generic right now. As others begin producing it market pressure will hopefully drive those costs down. It’s also worth noting that some insurance companies have recently begun classifying it as preventative medicine (as it should’ve been this whole time) and covering it at 100%.
- ceejayoz 6y ago> As others begin producing it market pressure will hopefully drive those costs down. That's the idea, but it doesn't really work that way. https://hbr.org/2017/04/how-pharma-companies-game-the-system-to-keep-drugs-expensive https://hbr.org/2017/04/how-pharma-companies-game-the-system... > One of the ways branded drug manufacturers prevent competition is simple: cash. In so-called “pay for delay” agreements, a brand drug company simply pays a generic company not to launch a version of a drug. The Federal Trade Commission estimates these pacts cost U.S. consumers and taxpayers $3.5 billion in higher drug costs each year. and this fun one... > Another way pharmaceutical firms are thwarting generics is by restricting access to samples for testing. Generic drug makers need to be able to purchase a sample of a brand-name product to conduct bioequivalence testing. That’s because they have to prove they can make a bioequivalent product following the current good manufacturing practices (CGMP) standard. These manufacturers don’t need to conduct clinical trials like the original drug company did. > But the original drug developer often declines to sell drug samples to generics manufacturers by citing “FDA requirements,” by which they mean the agency’s Risk Evaluation and Mitigation Strategies program. The idea behind this program is a good one: give access to patients who will benefit from these personalized medicines, and bar access for patients who won’t benefit and could be seriously harmed. However, brand drug makers are citing these requirements for the sole purpose of keeping generics from coming to market.
- ChickeNES 6y agoWhy does this falsehood keep being repeated as the truth?
- heavyset_go 6y ago> In particular, how easy will distribution be, considering that HIV is extremely easily preventable but it still spreads, because of lack of distribution of knowledge, I assume. This is a huge problem in the US. Truvada must be taken everyday to prevent HIV, and in 2015, it cost $1400 for a 30 day supply. In 2021, it costs between $1900 and $2500+ for a 30 day supply in the US. Elsewhere in the world, Truvada might cost $40. In Australia, Truvada costs $8 for a 30 day supply[1]. The only other drug approved for PrEP in the US is Descovy, which is manufactured by Gilead, too, and costs $2300+ minimum for a 30 day supply. [1] https://www.independent.co.uk/news/world/americas/us-politics/aoc-hiv-drug-cost-us-australia-ceo-gilead-video-a8919316.html https://www.independent.co.uk/news/world/americas/us-politic...
- rafale 6y agoWhy doesn't the US pass a law that prevent such large deprecencies? Is it because the legal landscape is different and pharmaceuticals companies worry about the cost of litigation in the US?
- GiorgioG 6y agoBecause the passage of laws is bought and paid for by corporations.
- toomuchtodo 6y agoBecause Big Pharma lobbies to prevent such laws from being imposed. There’s even a law that prevents Medicare from negotiating down the price of drugs, with obvious consequences.
- rtkwe 6y agoBecause the GOP is ideologically opposed to price controls (except when it's in the form of subsidies to their state's pet industry of course). Something, something, free market distortions I think is the usual reason.
- midasuni 6y ago
- peter303 6y ago15,000 people a year still die in the US with HIV. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...
- ufo 6y agoThis vaccine doesn't prevent infection by HIV so it's not ready for real world use. What it does is prime the immune system so that a second vaccine might become more effective. The second vaccine still needs to be developed though
- Blikkentrekker 6y agoH.i.v. spread is not so easy to prævent as many think. Many seem to think that the use of a condom turns transmission risk from 99% to 0% or something along those lines. The reality is more so that it changes 1% to 0.3%, and it heavily depends on the sex act and direction of transmission as well. Another not so often sung fact is that the transmission rate from patients who take blockers properly, and thus have an undetectable viral load is 0%. https://www.aidsmap.com/about-hiv/estimated-hiv-risk-exposure https://www.aidsmap.com/about-hiv/estimated-hiv-risk-exposur...
- aemreunal 6y agoWow that link has been super informative, thank you! I knew that the transmission risk was actually lower than commonly thought but wasn't aware that it was direction- and sexual act-dependent, nor that condoms were of great but still limited effect. Thanks!
- Blikkentrekker 6y agoIn fact, receptive penio-anal sex has about 17 times as high a transmission rate than receptive penio-vaginal sex, which an order of magnitude more difference than what a condom can make in either. The difference a condom makes is quite comparable to being the receiver or penetrator in penio-vaginal sex, in fact.
- deleted 6y ago[deleted]
- foldr 6y agoIf you look at the link below, you’ll see that the 70% figure comes from a study of repeated sex over time (with self-reported condom usage), and so can’t be applied to the figures for a single sex act. Preventing semen from coming in contact with the vagina/anus will reduce transmission risk to effectively zero, and condoms don’t break all that often. Correct condom use will make you as an individual much safer. But as a public health strategy, telling people to use condoms has a significant but limited effect. More info here: https://www.aidsmap.com/about-hiv/do-condoms-work https://www.aidsmap.com/about-hiv/do-condoms-work
- eli 6y agoDistribution? There’s no evidence that it works yet