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FDA approves first monthly injectable to treat HIV infection

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Re: FDA approves first monthly injectable to treat HIV infection

#31

Post by icegreentea2 »

Merman_Mike wrote: post #5
transfire wrote: post #4

[flagged]

Instead of downvotes, I'm curious what evidence there is on either side of this claim.

The claim logically holds together. There is even evidence on its side.

But one reason for the downvotes may be that it might be too narrow-minded. For one thing, it completely neglects to consider the relative difficulty of treating symptoms versus being fully curative. Secondly, it half undermines itself by lumping vaccines into the same bucket as symptomatic treatment. Clearly the economic incentives for vaccine, versus symptom management, versus cure depends on the disease being treated.

Finally, while it carefully uses the word "incentive" instead of talking in black and whites, it doesn't explain why "big pharma" makes cures at all. A lot of the the supporting material for "pharma makes more money on symptom treatment" references Gilead's experience with Hep C. But the economics of how that drug would have worked was clear as day before Gilead spent resources of it. So why would Gilead have gone to market with a cure at all?

Re: FDA approves first monthly injectable to treat HIV infection

#32

Post by jliptzin »

> In 2018, for instance, there were approximately 36,400 newly infected patients living with HIV in the U.S.

It's 2021, why are we only seeing 3 year old HIV infection numbers? How come I can see coronavirus infection numbers updated pretty much hourly but reporting on HIV infection rates in this country is lagging 3 years?

Re: FDA approves first monthly injectable to treat HIV infection

#33

Post by just_steve_h »

ed25519FUUU wrote: post #28

> In 2018, for instance, there were approximately 36,400 newly infected patients living with HIV in the U.S. This number seems insane to me in the USA . Why is a well known deadly disease, with well understood transmission vectors, still spreading so prominently here?

Why is it spreading? Because ACCESS TO CARE is extremely unevenly distributed. It can be extremely difficult for people with limited resources to get proper care.

Re: FDA approves first monthly injectable to treat HIV infection

#34

Post by JumpCrisscross »

Merman_Mike wrote: post #5
transfire wrote: post #4

[flagged]

Instead of downvotes, I'm curious what evidence there is on either side of this claim.

> I'm curious what evidence there is on either side of this claim

Looking at the list of the most deadly non-tropical infectious diseases [1], most can be vaccinated against and/or cured. The standouts remain lower respiratory infections, e.g. influenza, and HIV/AIDS.

When confronted with a novel coronavirus, it took a few months for the world's medical systems to devise various treatments and a vaccine. Neither of those are recurring revenue streams.

Most damning to this conspiracy theory is the recent Hep C cure. That's a real disease. It was profitable to treat. But it's more profitable to cure. Those incentives remain elsewhere. A cure for HIV is worth billions.

Dealing with mortality and sickness is difficult. It's more comforting to some to imagine an evil cabal holding back medicine, and I don't need to take that from them. But if you're entertaining these thoughts as anything more than a coping mechanism, the last half century--or even decade--of progress in curing, not treating, curing a variety of medical issues has been under-reported (lots of niche illnesses) and breathtaking.

[1] https://en.wikipedia.org/wiki/Infection

Re: FDA approves first monthly injectable to treat HIV infection

#35

Post by damnyou »

bpodgursky wrote: post #29
ed25519FUUU wrote: post #28

> In 2018, for instance, there were approximately 36,400 newly infected patients living with HIV in the U.S. This number seems insane to me in the USA . Why is a well known deadly disease, with well understood transmission vectors, still spreading so prominently here?

Because people really, really like having risky and unsafe sex?

No, that's not the reason, given that PrEP exists. The actual reason is that Truvada, like other healthcare, can be hard to get in the American system.

Re: FDA approves first monthly injectable to treat HIV infection

#36

Post by ceejayoz »

jliptzin wrote: post #32

> In 2018, for instance, there were approximately 36,400 newly infected patients living with HIV in the U.S. It's 2021, why are we only seeing 3 year old HIV infection numbers? How come I can see coronavirus infection numbers updated pretty much hourly but reporting on HIV infection rates in this country is lagging 3 years?

COVID takes a few days to show symptoms and get diagnosed. HIV takes a lot longer.

https://www.onlineathens.com/news/2017-11-28/cdc-lag-time-be...

> In their monthly Vital Signs report out Tuesday, the Centers for Disease Control and Prevention reported that the median time between infection and diagnosis with HIV was three years in 2014, about seven months shorter than in 2011.

If you got HIV in 2020, chances are you don't know about it yet.

Re: FDA approves first monthly injectable to treat HIV infection

#37

Post by JumpCrisscross »

incrudible wrote: post #25
dougmwne wrote: post #12

Earlier quoted context omitted.

I am sure there is some evidence on both sides, but at the end of the day, people get into medicine and medical research to heal people, not keep them sick. The USA does not have the only medical system in the world and many countries run their systems with the goal of controlling costs, not increasing them. I don't think this kind of pessimistic conspiracy thinking adds to the conversation.

If there's more money to be made from keeping people sick than outright curing them, that logically is a disincentive from curing them. It's not conspiracy thinking to look at the incentive structures within systems to predict possible negative outcomes. Of course, there's a moral incentive to not keep people sick, but history shows that we can not rely on people acting morally. The pessimism is justified. If we expe…

> It's not conspiracy thinking to look at the incentive structures within systems to predict possible negative outcomes

It is when one mischaracterizes the system.

Medical research is not an oligopoly. It is oligopolistic within some domains, but as we've seen with the Covid vaccine, there are at least four nation-state domains (e.g. Russia, China, India and "the West") operating competitively, and within those domains, there are varying degrees of competitiveness (e.g. Pfizer vs. Moderna vs. AstraZeneca).

If you have a cure to something everyone else can only treat, you'll make a money selling the cure and taking your competitors' market share. Because if you don't, they will. It's a classic cartel / prisoner's dilemma problem with the added explosive of a multi-decade patent-protected monopoly for the first mover.

Re: FDA approves first monthly injectable to treat HIV infection

#39

Post by damnyou »

daniel957 wrote: post #19
dougmwne wrote: post #6

I have always heard that Truvada (prep) was extremely effective at preventing HIV infection. These new injectables are reported by the article to be 89% and 66% more effective at preventing transmission. What is this based on? Was I misinformed about Truvada's effectiveness? Is this a decrease in an already very low chance of transmission? Or is this in comparison to people forgetting to take their daily pills vs a s…

Logistics-wise, it’s easier to get someone to come into the doctors for blood work every 3 months for testing (as required for prep) than once a month for a shot. However, from reading the article, I do think there’s a convenience factor at play related to the struggles of taking pills daily. Note though, the article mentioned a trial of _women_ where truvada and one-shot prevention effectiveness were compared and th…

I'm not sure about this one but subcutaneous and intramuscular injectables are pretty easy to self-administer. I self-inject once a week myself.

https://www.poz.com/drug/cabenuva seems to suggest it is intramuscular (administered in the buttocks, which is not hard to do by oneself) but requires a healthcare provider. Not sure why, there might be storage requirements and such.

Re: FDA approves first monthly injectable to treat HIV infection

#40

Post by renewiltord »

damnyou wrote: post #35
bpodgursky wrote: post #29

Earlier quoted context omitted.

Because people really, really like having risky and unsafe sex?

No, that's not the reason, given that PrEP exists. The actual reason is that Truvada, like other healthcare, can be hard to get in the American system.

Have we considered telling people to "just stay home" and to "not have sex"? Maybe that's the trick.
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