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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

#81

Post by daniel957 »

damnyou wrote: post #39
daniel957 wrote: post #19

Earlier quoted context omitted.

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.

I think people would rather prefer to take a pill than give themselves an injection. It doesn’t matter if it’s “easy” or not. There’s the “ick” or “ahhh needle” or “breaking skin” factor at play.

Even if you self-inject and find it easy, I’m sure you’re not saying it’s easier and less of a hassle than taking a pill lmao.

Re: FDA approves first monthly injectable to treat HIV infection

#82

Post by abeppu »

abeppu wrote: post #73

> The cost, however, is steep — the list, or wholesale, price is $3,960 a month, or more than $47,500 a year. The list price for the one-time initiation dose is $5,490. Median income in the US is ~$31K apparently. So even in a rich country, this is like 50% more than the income of a typical person. My understanding is the funding for the trials was partly from NIAID. This seems like yet another case where public fund…

Or to approach the same issue from the other direction: Does public funding for research of this type self-sabotage, if it enables pharmaceutical companies to set pricing at a level which meaningfully limits the use of the results of that research?

Re: FDA approves first monthly injectable to treat HIV infection

#83

Post by timr »

abeppu wrote: post #73

> The cost, however, is steep — the list, or wholesale, price is $3,960 a month, or more than $47,500 a year. The list price for the one-time initiation dose is $5,490. Median income in the US is ~$31K apparently. So even in a rich country, this is like 50% more than the income of a typical person. My understanding is the funding for the trials was partly from NIAID. This seems like yet another case where public fund…

> My understanding is the funding for the trials was partly from NIAID.

I have no particular insight into the pricing of this drug, but in general, NIAID funding doesn't get anywhere close to the level of investment needed to bring a drug to market (NIAID's total budget is something like $5Bn. A single drug can easily require that much money to go to market).

Moreover, it isn't a bright-line distinction between public and private funding: if a novel drug is developed (entirely privately) against a target for which academic researchers once received public funds, does it count as public funding? There's a huge gray area in between. Nearly all drugs can be characterized as "publicly funded", if you look hard enough.

Rules like this sound great, but in practice, they'll lead to perverse incentives (like drug companies completely avoiding targets from the academic world, in the previous example). Nobody rational wants to spend billions of dollars doing late-stage development and clinical trials to be torpedoed by a researcher who took a small amount public funding decades prior.

Re: FDA approves first monthly injectable to treat HIV infection

#84

Post by joshuaissac »

abeppu wrote: post #73

> The cost, however, is steep — the list, or wholesale, price is $3,960 a month, or more than $47,500 a year. The list price for the one-time initiation dose is $5,490. Median income in the US is ~$31K apparently. So even in a rich country, this is like 50% more than the income of a typical person. My understanding is the funding for the trials was partly from NIAID. This seems like yet another case where public fund…

> So even in a rich country, this is like 50% more than the income of a typical person.

Generic versions of expensive American drugs tend to be released by Indian pharmaceutical companies into developing countries after a while.

Re: FDA approves first monthly injectable to treat HIV infection

#85

Post by eznzt »

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?

I could tell you, but I would get banned from this website.

Re: FDA approves first monthly injectable to treat HIV infection

#86

Post by xiphias2 »

lake-effect wrote: post #56

Pharmacy (i.e. the cost of drugs) is a big contributor to rising healthcare costs and injectables are an increasingly more popular and very expensive way to deliver drugs. This is a good example of how R&D and drug development works in the US. Invest time and energy in a much more profitable form of treatment for a disease that is already managed.

All the low hanging fruit for medical treatments have been done already, so right now it's incredibly hard to improve on the situation.

I'm really hopeful though about the genetic revolution that's happening though, I just wish it was happening faster (my girlfriend just got diagnosed with cancer again today :( )

Re: FDA approves first monthly injectable to treat HIV infection

#87

Post by dang »

Merman_Mike wrote: post #74
dang wrote: post #63

Earlier quoted context omitted.

It was a generic ideological flamewar tangent. That includes several good reasons for downvoting. https://news.ycombinator.com/newsguidelines.html

. [just gonna stop commenting on this site]

> Is the flamewar tangent part of this the comment on capitalism or "Capitalized medicine"? Doesn't really seem flamie to me but obviously others disagree.

The problem is the generic ideological tangent. You can perhaps (maybe!) imagine a substantive article and thread on the economics of cures vs. treatments. But that would require different initial conditions—primarily an interesting, informative article that brought lots of relevant information. Relevant information is flame retardant.

The situation is different when the topic is "FDA approves first monthly injectable to treat HIV infection" and the comment is swerving generically into "capitalized medicine". Generic tangents, especially when the impetus is snarky or unsubstantive, make threads reliable less interesting, and generic ideological tangents almost always turn into flamewars. The reason is that there's very little specific information to discuss—that's the meaning of "generic".

Off-topic tangents can be great when they're unpredictable and curious, but generic tangents are the opposite of that. They're more like getting sucked into the gravitational field of a much larger body, if not a black hole, that pulls all nearby topics toward itself and renders them all the same. Avoiding repetition is the biggest problem that a forum like HN—dedicated to curiosity—actually has, so it's a big deal: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so....

I hope this helps explain things a bit. There are lots of past explanations at https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor... also, but you'll unfortunately—and ironically—have to wade through some generic repetition to find the interesting bits.

Re: FDA approves first monthly injectable to treat HIV infection

#88

Post by FalconSensei »

ceejayoz wrote: post #36
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 yo…

Couldn't find on the linked article, but what's the lag for people who actually get tested?

I mean, seems that this 3 years lag is because people only get tested if they have any apparent health issue and the doctor thinks it might be HIV.

With Covid, it might take a few days for a test show positive, after exposure - say, Christmas dinner. If someone thinks they might have been exposed to HIV, how long until a test can safely tell it's a true negative/positive?

Re: FDA approves first monthly injectable to treat HIV infection

#89

Post by call_me_dana »

jjcon wrote: post #30
incrudible wrote: post #25

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…

There are indeed huge profit incentives for a cure. There are even larger profits to be had from a monthly treatment that the patient has to take for the rest of their lives.

Are you saying people that aren’t taking a monthly biologic injection for example will start coming out of the woodwork for a cure when normally they wouldn’t seek treatment for their malady?

Re: FDA approves first monthly injectable to treat HIV infection

#90

Post by samatman »

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.

Coming up with a cure for HIV infection would be an easy Nobel Prize in medicine.

That's a pretty powerful motive, historically. If you want to argue that it doesn't apply here, the burden, I'm afraid, is on you, not us.

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