181–190 of 237 posts
PrEP has negative side effects (besides being quite expensive for the state), condoms on the other side, don't have side effects, and are cheap. It's a matter of having some sense of personal responsibility really.
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> I am showing personal responsibility by both myself and my husband using Prep and getting tested regularly. Can't understand why you need PrEP unless you or your husband have unprotected sex outside marriage. That's the personal responsibility needed for both you and your husband: not having unprotected sex with other partners. Again, can't see why the state or the other people paying their health insurances should…
We are both on prep because we are in an open relationship, and yes sometimes that involves "unprotected" sex. Again though, if it was not for the fact that the US continues to charge significantly more than any other country I would happily pay for it myself. I already pay for the copay. I am not personally asking for the government or anyone else to pay for my Prep. But, as it is we offer condoms for free if you kn…
And Prep won't protect you against the myriad other horrible STDs apart from HIV/AIDs now will it?
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That would be men-who-have-sex-with-men, those with infected partners, sex workers, and intravenous drug users. That is a fairly large number of the population that would be placed on an expensive drug with several side effects.
I would honestly just say anyone that is not in a monogamous relationship. Straight men/women can easily have it and one fuckup and you can be infected
What you are describing makes absolutely no sense for straight men or women that don't have unprotected anal sex.
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My point was that "at risk" means "seriously at risk", not "well, you are theoretically at risk, so better safe than sorry". If you're statistically not very likely to be infected, the side effects may outweigh the good. > if this was a vaccine most people would probably not question taking it Doctors would, or so I hope, not recommend taking a vaccine with serious side-effects without a reason. You typically don't g…
I can agree with that. Maybe I should rephrase that, anyone in not in a monogamous relationship (and having sex) should at least discuss it with their Doctor and see if it would be worth them being on. I find it shocking when I am talking to someone and find out they have no idea that prep even exists.
Anyone not in a monogamous relationship that has (unprotected) anal sex with different men.
Nothing else makes statistical sense. There is such a thing as a precautionary principle for medicine and it goes against most of what you wish to be.
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> I am showing personal responsibility by both myself and my husband using Prep and getting tested regularly. Can't understand why you need PrEP unless you or your husband have unprotected sex outside marriage. That's the personal responsibility needed for both you and your husband: not having unprotected sex with other partners. Again, can't see why the state or the other people paying their health insurances should…
We are both on prep because we are in an open relationship, and yes sometimes that involves "unprotected" sex. Again though, if it was not for the fact that the US continues to charge significantly more than any other country I would happily pay for it myself. I already pay for the copay. I am not personally asking for the government or anyone else to pay for my Prep. But, as it is we offer condoms for free if you kn…
Well, if we're focusing on society as a whole, then it could be argued that your doctor is right for discouraging promiscuity, since STDs tend to affect society at large as they spread.
>So why the fuck is prep so different.
Because it's an expensive medication, it's the only effective "treatment" for HIV, and just like overprescription of antibiotics, excessive use of prep is leading to resistance. So, arguably, these personal choices have serious consequences for society.
And I think it's disingenuous to frame this as anti-LGBT and/or sex shaming. Yes, barring access to prep disproportionately affects gay men, but that's because gay men are the ones who predominantly need it, and their individual, ostensibly private sexual choices are impacting the rest of us.
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Your message seems, at least to me, to be quite judgmental. I'm interested in helping people who make bad choices and people who have bad luck. It's not clear to me that one group deserves more compassion than the other. The comparison to cancers is a bit odd - HIV is generally not regarded as a lifestyle disease, while of course many cancers do have a lifestyle component. HIV is communicable; the time and money spen…
I find it odd that HIV is not a lifestyle disease. Everything I know about it says that someone is at zero risk if they take lifestyle precautions. Is there some risk to someone who doesn't do drugs and is in a monogamous relationship? That is they might catch it from someone near them (like the flu from a cough). Or is the definition of lifestyle disease different from what I intuitively think it is, so HIV doesn't…
When I think of a "lifestyle disease", the first thing that comes to mind is type 2 diabetes. The actual disease is part of a lifestyle of chronic behavior that is linked to this particular bad health outcome. Someone can contract it regardless of their lifestyle.
Sure, there are potential lifestyle components to the way that the HIV virus is transmitted. Some people exposed to this pathogen will contract HIV. Of those, some will develop AIDS.
But that doesn't mean that the lifestyle is the cause of the disease; the pathogen is the cause.
As for the higher-level judgment: some people want to do drugs, and most people aren't in (and don't want to be in) monogamous relationships. The health of these populations is just as valuable as any other, no? It's perfectly possible to do both of these things and be healthy; the fact that some pathogens can be transmitted via these media makes it worth fighting these pathogens (while also of course educating people to engage in these activities more safely).
> HIV seems to be getting an out sized share of research compared to other things that kill more people.
Oh, yeah, if that's the point, I absolutely agree with that.
An easy place to start is traffic fatalities. It's not difficult to reduce these, but it costs both money and willingness to change driving habits. And of course traffic accidents kill many, many more people than HIV.
And heart disease. And opiod overdoses. And medical malpractice.
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I assume you meant per person?
No per year per person. The NHS prescribes it long term for various high risk groups. $6000 for a 'one off' course of treatment sounds very expensive.
The NHS does not prescribe PEP long-term for anyone.
For HIV+ people, it prescribes HAART, which everyone who has HIV should be on.
HIV- people can take PrEP, which is different from PEP and does not include any NNRTIs.
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In the US, we’re paying obscene prices because no other country pays their fair share to recoup the cost of development plus bringing the drug to market plus a reasonable margin for the effort. The US should establish an agreement whereby US patients pay a LOT less but that the foreign patients need to pay the same. The amount the industry earns should be low enough to make it reasonably financially accessible to pat…
> During the quarter [2019 Q2], Gilead generated $2.2 billion in operating cash flow, repaid $500 million of debt, made dividend payout of $800 million and spent $588 million on share buybacks. > Adjusted product gross margin was 87.3% compared with 84.2% in the year-ago period. Research & development (R&D) expenses were relatively flat at $916 million. Selling, general and administrative (SG&A) expenses increased 20…
What about when you take all the pharma companies and average how well they do over several years? The average net profit margin for the industry is 14.05% according to a January 2018 study by New York University’s Stern School of Business.
14.05%, not great, not terrible.
In addition, the overwhelming majority of those dividends and share buybacks from one company are subsequently plowed back into the industry in different companies depending on which of those companies are working on the most profitable drugs.
source: I have several friends that control a lot of AUM that specialize in pharma investments.
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Monosopy doesn't depend upon anything the US does. They have local control of IP even if they tied it to others. There would be costs involved but they can always tell them to get stuffed and manufacture their own if they won't be reasonable. Notably there is a lack of pharmaceutical companies who decide to abandon world markets entirely because positive N is always greater than 0.
I mean US produces recently the 57% percent of new drugs. https://media.xconomy.com/wordpress/wp-content/images/2014/0... I am not sure this explains the discrepancy between the healthcare cost between US and Switzerland. More in depth analysis: "There were two causes of this massive increase: government policy and lifestyle changes. First, the United States relies on company-sponsored private health insurance. The g…
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What a snide reply. Is it necessary to be a doctor to have an opinion on healthcare policy?
Would you feel comfortable as a layman arguing with people who have been studying the topic for a decade about the tradeoffs involved?