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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

#61

[flagged]

"Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents." https://news.ycombinator.com/newsguidelines.html

Especially not generic ideological tangents: https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor...

Re: FDA approves first monthly injectable to treat HIV infection

#63

Earlier quoted context omitted.

I don't really understand the downvotes and reactions of the other commenters to the gp's post. There's a whole bunch of studies showing there's less incentive to find cures opposed to ongoing treatments under for profit health systems. On a website where products as a service are discussed regularly i'm confused as to how the parallels between that and profit driven 'healthcare as a service' are ignored or looked at…

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It was a generic ideological flamewar tangent. That includes several good reasons for downvoting.

https://news.ycombinator.com/newsguidelines.html

Re: FDA approves first monthly injectable to treat HIV infection

#64

Earlier quoted context omitted.

> 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 t…

I came here to post about the Hep C cure. You did a great job. Only thing I would embellish on is that, much like software - when something is wrong its easier to treat the symptoms than to fix the problem a lot of the times. So it's really no wonder alot of treatments are amelioration rather than cures. I recently did a major refactor at work to fix database and caching problems in our backend. It took months but on…

Could you please stop creating accounts for every few comments you post? We ban accounts that do that. This is in the site guidelines: https://news.ycombinator.com/newsguidelines.html.

You needn't use your real name, of course, but for HN to be a community, users need some identity for other users to relate to. Otherwise we may as well have no usernames and no community, and that would be a different kind of forum. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...

Re: FDA approves first monthly injectable to treat HIV infection

#65
post #30

Earlier quoted context omitted.

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…

> we at least must allow them to profit as much or more from a cure as they would from a treatment I think that’s where you go wrong. There are huge profit incentives for a cure. If a biotech company comes up with a cure they will instantly have the business of every afflicted person on the planet. The market for that and price they can charge will be way larger than a slightly different treatment. Beyond that, there…

[deleted]

Re: FDA approves first monthly injectable to treat HIV infection

#66
post #14

Earlier quoted context omitted.

I'm not sure every claim is worthy of debate. Setting aside all the private investment and philanthropy dollars going towards a cure, governments spend billions annually on HIV research.

Yes, they spend billions on developing the exact types of treatments that this article is about. Their business model depends on maximizing revenue so any treatment cannot cure the patient and it cannot kill the patient. Sad, but true.

The business model of the NIH and the UN does not depend on maximizing revenue

Re: FDA approves first monthly injectable to treat HIV infection

#67

Earlier quoted context omitted.

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 t…

The Hep C cure wasn't all that profitable, from what I understand. On paper it was a clear win-win - the cure would save the various healthcare services lots of money compared with treatment, whilst still raking in boatloads of money. The trouble is that healthcare services everywhere balked at buying it regardless of their structure and despite the fact that not doing so would cost them money in the long term, and even at those rejected prices it wouldn't have been nearly as profitable as a long-term ongoing treatment because it eliminates its own customer base.

Re: FDA approves first monthly injectable to treat HIV infection

#68
As someone who is in this high-risk community: good news.

(Well, except for that price tag.)

People, to a first approximation, are just terrible at pill compliance. Doesn’t matter the demographics, people just aren’t perfect at taking a pill, every day, at the same time, forever and ever. Having that injection where you can set it and forget it? Nice advance. Not game-changing, but still a nice move forward.

And I think it’ll be a bigger move forward for people who are at high risk of HIV, but also have not great access to medical care where they live. If you…oh boy, here I go, potentially getting into trouble. Non-white and/or non-affluent communities tend to come down much harder on homosexuality. It is much more discreet to get a periodic shot than heading to Walgreen’s and bringing home a bottle full of blue pills. It’s safer. It’s a bit more private.

Re: FDA approves first monthly injectable to treat HIV infection

#69
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…

It is a decrease in already low transmission. For ethical reasons, the placebo group is not no treatment, but rather current standard of care. I had to do some digging to find any source on the effectiveness on preventing transmission (the recent FDA approval is for post infection treatment). The study I found is [0]. In a double blinded study of 4,600 participants, half were given the cabotegravir injection, and hal…

This is awesome, thank you! The likelihood of pill compliance does seem to be probably higher than normal since everyone had 2 month follow-up appointments for injections, plus presumably they knew they were being blood tested. This looks like a game changer for HIV prevention. 6 shots a year and you can have better protection than any other known method. To me it looks like this is something that should be rapidly adopted.

Re: FDA approves first monthly injectable to treat HIV infection

#70
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…

Compliance is a big issue, as is price. In the US, Truvada's retail price is about $2,000 for a 30 day supply. Truvada costs about $40 in other countries.
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