4 ms·

That's a legit question: drugs are now day tested in Europe on a relatively small and strictly controlled cohort and in China/India/Africa on much larger cohor

That's a legit question: drugs are now day tested in Europe on a relatively small and strictly controlled cohort and in China/India/Africa on much larger cohorts with much different rules. It's easier and cheaper to test new drugs outside the us/eu because laxer regulations.

Wytwwww 2y ago
Or rather (due to obvious reasons) you just couldn't get a meaningful sample and would just be wasting resources/money if you conducted this test in US/EU.
- ABCLAW 2y ago
  Not really. When performing clinical trials, if you'd like to use the results of the studies in chinese/indian populations you'll need to prove bioequivalence in many cases, so you're going to need to collect a meaningful sample in the first place. The reality is that most clinical trials aren't successes. If you can get a huge cohort of people for relatively cheap elsewhere, you can screen a lot of promising but doomed tests at a cheaper price point, then only re-create similar testing on the most promising candidates in your lucrative markets.
  - lolc 2y ago
    What the grandparent post was referring to as "obvious reasons" must be the high prevalence of HIV in the study countries[0]. Why wouldn't they test in countries with the highest infection risk? There may be common reasons to trial there like it being cheaper or less regulated. But there is a good reason for this specific medication to be tested in those specific countries. Criticizing the study authors for being "cheap" is uncalled for in this case. [0] https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme?time=latest https://ourworldindata.org/grapher/share-of-population-infec...
  - Wytwwww 2y ago
    I'm not sure developed countries are the most lucrative market for HIV vaccines. How many people would even get them and why? This is a product almost entirely developed for Sub-Saharan Africa so it only makes sense that they focus on testing it there? Hard to say, maybe it's not inconceivable that ~1% of potential patients in the US/EU/etc. might end up paying more than > 50%-90% of the people living Sub-Saharan Africa for whom getting the vaccine would make a lot of sense.
x0x0 2y ago
> It's easier and cheaper to test new drugs outside the us/eu because laxer regulations. Given your comments elsewhere I suspect you're claiming this with no evidence. For other readers, this isn't true / it's drug dependent. Amongst other things: difficulty sourcing the correct patients; difficulty importing drugs, particularly because they're not yet approved; difficulty getting high quality or reliable labs; etc. As any ctm could have told you. As for this drug: the US/EU don't have rampant hiv, esp with the use of PrEP.

Wytwwww 2y ago

Or rather (due to obvious reasons) you just couldn't get a meaningful sample and would just be wasting resources/money if you conducted this test in US/EU.

ABCLAW 2y ago
Not really. When performing clinical trials, if you'd like to use the results of the studies in chinese/indian populations you'll need to prove bioequivalence in many cases, so you're going to need to collect a meaningful sample in the first place. The reality is that most clinical trials aren't successes. If you can get a huge cohort of people for relatively cheap elsewhere, you can screen a lot of promising but doomed tests at a cheaper price point, then only re-create similar testing on the most promising candidates in your lucrative markets.
- lolc 2y ago
  What the grandparent post was referring to as "obvious reasons" must be the high prevalence of HIV in the study countries[0]. Why wouldn't they test in countries with the highest infection risk? There may be common reasons to trial there like it being cheaper or less regulated. But there is a good reason for this specific medication to be tested in those specific countries. Criticizing the study authors for being "cheap" is uncalled for in this case. [0] https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme?time=latest https://ourworldindata.org/grapher/share-of-population-infec...
- Wytwwww 2y ago
  I'm not sure developed countries are the most lucrative market for HIV vaccines. How many people would even get them and why? This is a product almost entirely developed for Sub-Saharan Africa so it only makes sense that they focus on testing it there? Hard to say, maybe it's not inconceivable that ~1% of potential patients in the US/EU/etc. might end up paying more than > 50%-90% of the people living Sub-Saharan Africa for whom getting the vaccine would make a lot of sense.

x0x0 2y ago

> It's easier and cheaper to test new drugs outside the us/eu because laxer regulations. Given your comments elsewhere I suspect you're claiming this with no evidence. For other readers, this isn't true / it's drug dependent. Amongst other things: difficulty sourcing the correct patients; difficulty importing drugs, particularly because they're not yet approved; difficulty getting high quality or reliable labs; etc. As any ctm could have told you. As for this drug: the US/EU don't have rampant hiv, esp with the use of PrEP.