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New antibody attacks 99% of HIV strains

bbc.com

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Re: New antibody attacks 99% of HIV strains

#221

Post by hn_throwaway_99 »

otakucode wrote: post #57
vkou wrote: post #17

Earlier quoted context omitted.

In the 1980s, getting HIV was a quick death sentence. In the 2010s, getting HIV means that you are likely to live until... Your 70s. (Assuming you have access to medication.) The problem is that you need to take expensive medication for the rest of your life. And that you can infect other people.

The infecting other people is mostly theoretical. As far as I know there is no actual instance of transmission from a person with an undetectable viral load on antiretroviral drugs to an uninfected person.

Is this somewhat of a tautology, though? I mean, it's not particularly uncommon for a patient to be undetectable on HAART and then have their treatment regimen "fail" at a later date (often because of lack of strict compliance by the patient - not sure if this is much less common today with easier-to-follow regimens).

Thus, if someone is undetectable but then their treatment fails, they would become detectable and able to transmit the virus. But they could still infect someone else before they discovered their treatment failed.

Re: New antibody attacks 99% of HIV strains

#223

Post by pkaye »

tertius wrote: post #216
tryingagainbro wrote: post #214

Earlier quoted context omitted.

The difference in pricing is STAGGERING. http://timesofindia.indiatimes.com/india/New-Hepatitis-C-dru... The blockbuster hepatitis C drug will cost about $900 (around Rs 54,000) in India for a 12-week course of treatment. That would be a fraction of the $84,000 (over Rs 50 lakh) price tag for the same treatment in US. I'm sure that they wouldn't be that profitable if USA paid $900 for that drug, especially the first…

Drugs are cheapest in India. Let's normalize. I.e. far end of the pricing bell curve. But the answer is still, yes, there is profitability. Just not as much as with the hyper inflated prices in the US. In short: Does the extreme cost for drugs in the US cause groundbreaking research to benefit the whole world? No, same results could be had with way less profit. Money to fund moonshot research is still important thoug…

Given the lower labor costs and people consider drugs to be so profitable, I don't know why other countries don't do as much research and drug development. Just a few countries carry the lion share of this effort.

Re: New antibody attacks 99% of HIV strains

#224

Post by refurb »

L_Rahman wrote: post #213
chasil wrote: post #68

Earlier quoted context omitted.

Antibody manufacture is not cheap. The antibodies are made by fusing the b-memory cells with mouse cancer, then putting the result in a bioreactor and filtering out the desired product, which must then be refrigerated. Drugs that use this technique commonly end in -MAB (for monoclonal antibody).

Given the entrenched nature of the American pharmaceutical industry, I'm unconvinced that any of them have actually tried to solve the problem of cheap antibody manufacturing at scale.

Why wouldn't they? Any reduction in cost is pure profit for them.

Re: New antibody attacks 99% of HIV strains

#225

Post by refurb »

elihu wrote: post #154
toast0 wrote: post #144

Earlier quoted context omitted.

This is the real heart of the healthcare cost problem in the US. No party in the process knows how much anything costs, so it's unsurprising that costs go up so fast. This wouldn't be tenable in an individual pays environment, or in a government pays environment, but in the US environment where many people get coverage from employment we end up in this crazy system where there are so many parties involved in payment,…

I didn't quite follow joshstrange's accounting so I don't know if this is what he's describing, but (unless it's been changed recently), in some states it's legal for manufacturer of an expensive medication to give coupons to customers to reimburse them for their copay. This sounds like a nice, generous thing to do, but basically it means that the drug company is bribing the customer to force their insurance company…

and then raise the price of the drug to $1200

It doesn't work like that unless you're the only drug in class. If there are alternatives, then you'll get kicked off the formulary for a 20% price increase.

Re: New antibody attacks 99% of HIV strains

#226

Post by refurb »

FabHK wrote: post #217
tryingagainbro wrote: post #187

Earlier quoted context omitted.

Drugs are cheaper and largely subsidized by governments with high incidence of HIV. I'm South African, antiretrovirals are free.* Almost got it right: Drugs elsewhere are cheaper and largely subsidized by USA citizens. Those drugs cost a fortune to make and the companies make their money in USA https://www.reuters.com/article/us-pharmaceuticals-usa-compa...

And yet, reportedly US pharmaceuticals spend more money on marketing and promotion (i.e. coddling up to the doctors who prescribe their products) than R&D. https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-p... https://www.sciencedaily.com/releases/2008/01/080105140107.h...

God I wish this myth would die.

First off, that's not sales and marketing expense. It's what accountants called "sales and general administration" which yes, marketing falls into, but so do a number of other items. It's not 100% marketing.

Second, the only reason why a company would spend money on promotion is if the return is >100%. So, if drug companies were to stop all promotion, their profit would actually fall, not go up. So it's not going to reduce the cost of drugs.

Third, I've talked to a number of physicians would appreciate the marketing that drug companies do. They don't have time to keep up on the latest, so a 15 minute chat with a drug rep might save them a lot of time. Of course, they know the marketing is biased, but it at least gives them a sense as to what's out there.

Re: New antibody attacks 99% of HIV strains

#227

Post by refurb »

tertius wrote: post #208
tryingagainbro wrote: post #187

Earlier quoted context omitted.

Drugs are cheaper and largely subsidized by governments with high incidence of HIV. I'm South African, antiretrovirals are free.* Almost got it right: Drugs elsewhere are cheaper and largely subsidized by USA citizens. Those drugs cost a fortune to make and the companies make their money in USA https://www.reuters.com/article/us-pharmaceuticals-usa-compa...

> Almost got it right: Drugs elsewhere are cheaper and largely subsidized by USA citizens. * Correction, by U.S. government (through law). > Those drugs cost a fortune to make and the companies make their money in USA. Yes R&D is expensive, but pharma is extremely profitable. Here in the U.S. and abroad.

pharma is extremely profitable

That's survivorship bias. Yes, the successful pharma companies are quite profitable, but there are 10 failed companies for every successful one.

I remember reading a paper that said the overall returns for the industry are either single digit or negative.

Re: New antibody attacks 99% of HIV strains

#228

Post by refurb »

pkaye wrote: post #223
tertius wrote: post #216

Earlier quoted context omitted.

Drugs are cheapest in India. Let's normalize. I.e. far end of the pricing bell curve. But the answer is still, yes, there is profitability. Just not as much as with the hyper inflated prices in the US. In short: Does the extreme cost for drugs in the US cause groundbreaking research to benefit the whole world? No, same results could be had with way less profit. Money to fund moonshot research is still important thoug…

Given the lower labor costs and people consider drugs to be so profitable, I don't know why other countries don't do as much research and drug development. Just a few countries carry the lion share of this effort.

That would be my response. If someone else can improve R&D and lower the cost of drugs, they are more than welcome to. Interestingly, I haven't seen any takers.

Re: New antibody attacks 99% of HIV strains

#229

Post by toast0 »

TimPC wrote: post #192
jahnu wrote: post #156

Earlier quoted context omitted.

Oh, wow... never even heard of that one. What a horror show.

As a Canadian in the US to me this feels like a different kind of horror show. I play bridge and as a result I've been exposed to quite a lot of the elderly dying as a result of chronic conditions given the demographics of the game/sport. In Canada, it seemed we had a charity fundraiser 2-3 times a year for someone affected by some condition the government didn't want to cover due to cost. In the US, I deal with a le…

There's certainly a discussion to be had on what level of care should be provided, how to pay for it, and what to do when the care required isn't provided.

I don't hear a lot of complaints about medicare not covering important things (but I only have limited exposure to that), and I assume a US single payer system would essentially be Medicare for all. I do hear complaints about Medicare not paying providers enough, and a lack of available providers.

A rational method of rationing care seems preferable to the current byzantine methods. My (likely naive) hope would be that spending the same amount of money on healthcare, but with fewer parties involved would provide more and better healthcare. At least we haven't reached the point where the government encourages smoking to decrease long term healthcare costs.

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