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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

#121

Post by s1artibartfast »

ryanmercer wrote: post #119
pgt wrote: post #108

Earlier quoted context omitted.

Genuinely curious - why do these drugs cost so much? Can we make it cheaper? I know there’s a lot of hit & miss and that the cost of the drug also covers the misses, but it feels like we should be able to do this for millions, not billions.

https://www.pcisynthesis.com/want-to-know-why-early-drug-dev... and http://sitn.hms.harvard.edu/flash/2020/modern-drug-discovery... are decent reads. Mostly it's the complexity of the compounds involved, the supply chain, and regulatory costs.

And the the time value of money. see my sibling post.

Re: FDA approves first monthly injectable to treat HIV infection

#122

Post by offtop5 »

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…

3k month sounds about right for a chronic condition.

Many many people pay at least this to stay alive. That said , Universal Health Care is needed for stuff like this to work. At 3k a month it makes the most sense to try and emigrate to a better country.

Re: FDA approves first monthly injectable to treat HIV infection

#123

Post by damnyou »

daniel957 wrote: post #104
damnyou wrote: post #101

Earlier quoted context omitted.

It is in fact much easier and less of a hassle (for me) than taking a pill everyday, which is what I used to do before I switched to injectables. Injectables seemed scary right until the moment when I started taking them, after which they became a normal part of my life.

In what way is it easier besides you saying that it’s easier? You have a hard time swallowing pills I guess? Or do you remember to take injections more because they stand out more in your mind than pills do? EDIT: Not sure why this is getting downvoted. Since when on HN is it acceptable for someone to say “I think this way so it must be a fact” without providing an explanation? Even when it comes to subjectivity, the…

I'm pretty sure that "easier" is a subjective determination. But no, I don't have a hard time swallowing pills. It's just that doing something once a week is easier than having to remember to do something everyday. The injections are also more effective for me, as they are here. And finally there's an aesthetic aspect to plunging a needle into one's muscle that I appreciate.

Re: FDA approves first monthly injectable to treat HIV infection

#124

Post by maxerickson »

taurath wrote: post #79
heavyset_go wrote: post #70

Earlier quoted context omitted.

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.

Compliance is a huge issue because health insurance will do a lot to make you jump through huge hoops to get it. I have had prescriptions “disappear” into the CVS “specialty pharmacy” and you have to wait on the phone for hours for them to “find” it.

I helped my mom deal with 2 specialty pharmacies for some Parkinson's drugs she was taking. The drugs weren't available from other pharmacies (that CVS runs one of the largest specialty pharmacies can make this confusing, but normal CVS probably don't stock it if the prescription goes to their specialty pharmacy).

They present themselves as helping the patient navigate a complex drug, but in practice this just meant they had a bunch of questions to tick off each time you talked to them. Their outreach and phone tree were both pretty bad, clearly designed for high operator utilization and not customer service.

Re: FDA approves first monthly injectable to treat HIV infection

#125

Post by Blikkentrekker »

apendleton wrote: post #117
Blikkentrekker wrote: post #109

Earlier quoted context omitted.

Then why isn't it done as such in all instances? It seems that whenever a perfect placebo be permissible, that is what is being used rather than the current standard of care. Soldiers can be sent to their death for oil and other resources that benefit the larger majority? but this is “yikes”?, not a phrase I find to occur in conjunction with rational decisions often.

> Then why isn't it done as such in all instances? It is. Control groups are no-treatment if no approved treatment exists, or current standard of care if there's an approved treatment. That's standard practice. > It seems that whenever a perfect placebo be permissible, that is what is being used rather than the current standard of care. If by "perfect placebo," you mean "no treatment," that's not correct, and is cons…

> It is. Control groups are no-treatment if no approved treatment exists, or current standard of care if there's an approved treatment. That's standard practice.

I've read plenty of pharmaceutical trials where the control was a plain placebo, not the current standard of care, when it not involve a life threatening illness.

https://clinicaltrials.gov/ct2/show/NCT00061802

Clearly this antipsychotics trial does not evaluate the drug 's effectiveness against the current standard of care's, but against a placebo's.

> If by "perfect placebo," you mean "no treatment," that's not correct, and is considered unethical.

I mean giving them a drug that lacks an active ingredient but is otherwise not to the lay eye discriminatable from an effective drug.

And that is very much what is done in the case of the antipsychotics medicine I showed. So it's only unethical when human lives be at stake, apparently.

Re: FDA approves first monthly injectable to treat HIV infection

#126

Post by [deleted] »

daniel957 wrote: post #104
damnyou wrote: post #101

Earlier quoted context omitted.

It is in fact much easier and less of a hassle (for me) than taking a pill everyday, which is what I used to do before I switched to injectables. Injectables seemed scary right until the moment when I started taking them, after which they became a normal part of my life.

In what way is it easier besides you saying that it’s easier? You have a hard time swallowing pills I guess? Or do you remember to take injections more because they stand out more in your mind than pills do? EDIT: Not sure why this is getting downvoted. Since when on HN is it acceptable for someone to say “I think this way so it must be a fact” without providing an explanation? Even when it comes to subjectivity, the…

[deleted]

Re: FDA approves first monthly injectable to treat HIV infection

#127

Post by reimertz »

m12k wrote: post #105
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…

> can we create an independent non-profit which receives ownership, and whose charter aligns with actually treating as many people as possible? There is a proposal for such an entity: https://en.wikipedia.org/wiki/Health_Impact_Fund

Independent non-profits trying to fight for individuals in a capitalist-driven society seems to be doomed to fail. An depressing example; Insulin and how the inventors made sure to make the the process available to anyone;

> The patent would not be used for any other purpose than to prevent the taking out of a patent by other persons. When the details of the method of preparation are published anyone would be free to prepare the extract, but no one could secure a profitable monopoly.

How did that go? 1,000% price increase, accounting for inflation. (US numbers)

Edit: Removed rant-driven generalization and miss-information regarding legal obligations.

Thanks for checking me. I get to upset reading these things.

Re: FDA approves first monthly injectable to treat HIV infection

#128

Post by daniel957 »

damnyou wrote: post #123
daniel957 wrote: post #104

Earlier quoted context omitted.

In what way is it easier besides you saying that it’s easier? You have a hard time swallowing pills I guess? Or do you remember to take injections more because they stand out more in your mind than pills do? EDIT: Not sure why this is getting downvoted. Since when on HN is it acceptable for someone to say “I think this way so it must be a fact” without providing an explanation? Even when it comes to subjectivity, the…

I'm pretty sure that "easier" is a subjective determination. But no, I don't have a hard time swallowing pills. It's just that doing something once a week is easier than having to remember to do something everyday. The injections are also more effective for me, as they are here. And finally there's an aesthetic aspect to plunging a needle into one's muscle that I appreciate.

Yes, it’s subjective to some extent, hence why I asked in what way is it easier beside you just saying that it is? I left out “to you” but I thought the HN community was a bit smarter than that. Even if you had said “it’s easier to me. Full stop,” I still would have written the same reply...

All you said was “it’s easier” in your original point. You obviously felt the need to clarify yourself in your most recent comment. So clearly your first comment was lacking information. There was no reason to downvote me just because you felt my original comment made you look stupid.

FWIW, even though “easy” is subjective, there’s still a consensus to be considered. For example, finding piercing your skin with a needle to be an asthetically-pleasing act does not fit that consensus...

Something that _does_ fit the consensus is that taking a pill every day is a hassle.

Stop being facetious just to prove a point.

Re: FDA approves first monthly injectable to treat HIV infection

#129

Post by jacquesm »

offtop5 wrote: post #122
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…

3k month sounds about right for a chronic condition. Many many people pay at least this to stay alive. That said , Universal Health Care is needed for stuff like this to work. At 3k a month it makes the most sense to try and emigrate to a better country.

That doesn't scale. If you push the cost of healthcare to other countries when it becomes too expensive instead of fixing the system in the country where you live then every other country with a better system's healthcare will collapse as well.

Vote to improve the system where you live and make sure that your representatives realize that it could be them or their relatives in your situation.

Quite a few countries have restrictions in this anyway, so whether it would even work in individual cases is another matter, for instance, here is Canada's provision:

https://www.canada.ca/en/immigration-refugees-citizenship/se...

Re: FDA approves first monthly injectable to treat HIV infection

#130

Post by [deleted] »

monopoledance wrote: post #113
perardi wrote: post #76

Earlier quoted context omitted.

It’s frustrating that it’s so expensive for the most at-risk communities in the US. Because you can totally work the systems to get it affordably. Besides insurance, there are clinics, there are coupons, there are programs…but you have to have the information literacy and the time to figure out how to jump through all those hoops. Me, I work remotely, I have insurance, I live on the north side of Chicago, I can get m…

I think, same as with vaccinations, this clearly highlights how all of society really benefits from universal health care. In fact, why isn't preventable infectious disease talked more about in that debate? Pretty obvious, no?

[deleted]
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