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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

#161

Post by damnyou »

daniel957 wrote: post #146
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…

He edited his comment to say “(for me)” after I had replied. Also, if you click damnyou@‘s comment history, you’ll clearly see that he loves using the phrase “in fact” without supporting his assumptions. I didn’t deserve to be downvoted.

My pronouns are they/them, thank you.

I edited my comment within a couple minutes of posting it. Sorry about the confusion.

Re: FDA approves first monthly injectable to treat HIV infection

#162

Post by Retric »

timr wrote: post #142
akiselev wrote: post #99

Earlier quoted context omitted.

> 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). According to [1] "the estimated median capitalized research and development cost per product was $985 million, counting expendit…

Yeah, $5Bn may be a bit of an exaggeration, but it's not off by an order of magnitude; this review, based on data from Eli Lilly, put the fully capitalized R&D number at $1.8Bn in 2010: https://www.nature.com/articles/nrd3078 (one can certainly quibble over the "cost of capital" assumptions these days, but the model isn't wildly wrong.) > That billion dollar figure is risk adjusted per product meaning that's the cost…

Globally there are ~50 new drugs per year. Total public and private spending on drug R&D hits ~190B per year. So even including government and charity donations your only up to 4 billion per drug. Private companies nominally cover ~60% of that dropping their investment to ~2.3 billion per successful drug.

However, that’s overly generous as a great deal of tax breaks etc indirectly subsidize that 2.3 Billion. So, it’s true drugs are expensive on average to create, larger numbers tossed around are generally intentionally misleading.

Re: FDA approves first monthly injectable to treat HIV infection

#163

Post by dmitrygr »

hn_throwaway_99 wrote: post #95
nceqs3 wrote: post #93

Earlier quoted context omitted.

I believe that the government does own a portion of the IP. If you read patents filed by defense contractors and pharma/universities they often say something like this "This invention was made with Government support under Contract no. F29601-03-C-0191 awarded by the Air Force Research Laboratory, Kirtland AFB, N. Mex. The Government has certain rights in the invention." https://patentimages.storage.googleapis.com/f9…

So then why is the government letting the company reap so much of the benefits of their IP?

So that when they want more research done, companies do not reply with: "you screwed us last time, NO THNX BYE"

Basically the same reason that "I changed the deal, pray i do not change it further" is a strategy that works at most once.

Re: FDA approves first monthly injectable to treat HIV infection

#164

Post by fastball »

Robotbeat wrote: post #115
fastball wrote: post #94

Earlier quoted context omitted.

How exactly are is big pharma limiting the result of that research? Anyone can use the research.

If the patents relating to likely avenues of that research are tied up, it makes it much harder.

How can you patent if there is open prior art?

Re: FDA approves first monthly injectable to treat HIV infection

#165

Post by jeffreyrogers »

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…

In the US most HIV drug manufacturers have coupons or other voucher programs that patients can use the reduce the price by a lot.

Re: FDA approves first monthly injectable to treat HIV infection

#166

Post by divbzero »

jklein11 wrote: post #149
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…

Does anyone actually end up paying the 47,500 a year for the drug or is this some sort of gimmick on the part of the drug company when they negotiate reimbursement rates with CMS or other payers?

This is a fair point. Negotiated rates are usually lower and the cost should be spread across a pool of insured people, not all of whom have conditions that require ongoing high-cost therapies. Other comments in this thread also point out that there are alternative HIV treatments from Gilead and others that cost less. If the demand is not there for the new monthly injectable, ViiV will suffer for mispricing its own drug.

Re: FDA approves first monthly injectable to treat HIV infection

#167

Post by grecy »

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.

> 3k month sounds about right for a chronic condition

My god, what a horrible way to look at life.

Re: FDA approves first monthly injectable to treat HIV infection

#170

Post by dougmwne »

daniel957 wrote: post #102
stickfigure wrote: post #92

Earlier quoted context omitted.

Depo-Provera (monthly injected contraceptive) is used by over 2 million women in the US.

Ok... and 10.6 million use birth control pills according to the CDC. Also, just because something appears convenient doesn’t mean that it actually is. Have you looked up how many women use one of those invasive contraceptive implants? Technically, a woman only has to get a new implant once every 4 years+. But have you not read the horror stories about the implants becoming dislodged and causing internal bleeding and…

You seem to be implying that IUDs are much less popular than the pill. That is not the case. They are just behind the pill in popularity.

Also, people on PrEP already need to do regular bloodwork, so needles and appointments are already involved every few months. Doing an appointment every 2 months instead of every 3 and not needing to take a daily pill as well is a huge win in level of effort.

https://www.cdc.gov/nchs/data/databriefs/db327-h.pdf

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