Alarming surge in drug-resistant HIV uncovered • Hacker News Board

Re: Alarming surge in drug-resistant HIV uncovered

#221

Post by ingenium » Fri, Aug 02, 2019, 5:33 PM UTC

Aloha wrote: post #14

jimbob45 wrote: post #2

Well, PrEP is a miracle drug that has gone criminally underutilized in the fight to eradicate HIV. It would be nice to see governments really push it hard for a change.

PrEP is hard to get, my doctor outright refused to prescribe it to me, they said they were not comfortable doing so

Go to a doctor or clinic that focuses on the LGBT community. It's very easy to get, and they'll take care of setting you up on the Gilead copay assistance program, so the medication should be completely free. Their program will cover up to $7,200/year in copays.

Re: Alarming surge in drug-resistant HIV uncovered

#222

Post by ingenium » Fri, Aug 02, 2019, 5:36 PM UTC

mm202018 wrote: post #9

sjaknanxnnx wrote: post #7

Earlier quoted context omitted.

My friend who’s on a high-deductible plan says they reimburse you for the portion that’s before your deductible. It’s actually kind of a sweet deal because you hit your deductible without being out any money. Then you don’t have to worry about paying for medical care for the rest of the year.

Who is “they”? There’s a copay card you can use from Gilead that helps pay your co-pay but not aware if that helps you hit out of pocket expenses before you hit your deductible or if that counts as your copay.

It depends on your insurance, but on some it will.

Re: Alarming surge in drug-resistant HIV uncovered

#223

Post by verulito » Fri, Aug 02, 2019, 5:38 PM UTC

jdietrich wrote: post #147

Geimfari wrote: post #116

Earlier quoted context omitted.

The drug has several non-minor side effects, is prohibitively expensive, and is the same as the treatment for someone who already has the virus. I for one think it's improper to prescribe a drug with these nephrological side effects to a large number of otherwise healthy individuals, not even accounting for the cost.

If it weren't for Gilead's legal efforts to extend the patent on Truvada, it'd be a dirt cheap generic by now; it already is in many countries. You might think it's improper, but the evidence says otherwise - PrEP is safe, well-tolerated, marginally cost-effective at proprietary prices and clearly cost-effective at generic prices. One of the fundamental principles of modern medicine is informed consent. Patients have…

I think PrEP is great and I don't think we do a great job of getting it to people for whom it makes sense. That being said, the CDC has an excellent position on who should be getting it and that's not a lot of people.

PrEP is well tolerated given it's known side effects but conservative medicine dictates that we don't prescribe medications unless we have a measurable benefit and that's not a large group of people. A homosexual male who has lots of unprotected sex with strangers should probably be on it. A hetereosexual mostly monogamous person probably shouldn't be.

A big factor here is that the prevalence of HIV in the US is low, at .34%. Globally it's a bit higher at .48%. It is also often not that contagious. That being said, under the right circumstances it could be so it's real important to be aware of the risk factors.

Re: Alarming surge in drug-resistant HIV uncovered

#224

Post by ingenium » Fri, Aug 02, 2019, 5:39 PM UTC

matthewmacleod wrote: post #208

quotemstr wrote: post #104

Earlier quoted context omitted.

Unless PrEP succeeds in eradicating HIV (which might be possible if enough people are on it to limit the spread of the virus), it seems tailor-made to breed resistance. We don't generally give antibiotics prophylactically. Using anti-retrovirals this way seems like a bad idea from a drug resistance perspective.

It doesn’t really work like that because of the lifecycle of HIV. If someone is using PrEP and is exposed to HIV, then either the drug works and they avoid infection (in which case there is obviously no impact on drug resistance) or they become HIV+. But in that case, they were either exposed to an already-resistant variant, or they were astonishingly unlucky and the drug failed to prevent infection - in which case,…

Or the person was not taking PrEP as prescribed, either missing doses or taking it inconsistently. Once they're infected, if they keep taking just Truvada, then that strain will begin developing resistance, which they can pass on, potentially to others taking PrEP correctly. There have been I believe 6 cases of people being infected with resistant strains while in PrEP.

That's why it's important for people taking PrEP to be screened regularly, and put on a proper cocktail if they test positive.

Re: Alarming surge in drug-resistant HIV uncovered

#225

Post by malandrew » Fri, Aug 02, 2019, 5:44 PM UTC

rowanG077 wrote: post #218

malandrew wrote: post #211

Earlier quoted context omitted.

14.05% is perfectly reasonable considering they are giving people hope for a better quality of life. Profiting off someone's misery would be when you cause the problem and provide the solution. If you merely recognize an existing problem and provide a solution where there previously was none or where the previous solution was inadequate/inferior. Attitudes like yours makes me not want to continue using my talent to c…

I don't agree at all. No profit should be had for developing medicine. You deserve a nice salary for your work but no profit should be made by the company.

Likewise, people who think that no profit should be had for developing medicine don't deserve the medicines that have been developed for profit.

Re: Alarming surge in drug-resistant HIV uncovered

#226

Post by rowanG077 » Fri, Aug 02, 2019, 6:22 PM UTC

malandrew wrote: post #225

rowanG077 wrote: post #218

Earlier quoted context omitted.

I don't agree at all. No profit should be had for developing medicine. You deserve a nice salary for your work but no profit should be made by the company.

Likewise, people who think that no profit should be had for developing medicine don't deserve the medicines that have been developed for profit.

Don't hate the player hate the game.

The consumer didn't choose to have greedy companies that like to make a quick bug over someones suffering.

Re: Alarming surge in drug-resistant HIV uncovered

#227

Post by dtornabene » Fri, Aug 02, 2019, 7:27 PM UTC

roel_v wrote: post #92

mantap wrote: post #87

Earlier quoted context omitted.

With the advent of air travel most of these geographically distant places are less than 24 hours away.

... That can still make them distant? Is Australia less 'distant' from Europe now that it takes 24 hours instead of 6 weeks to get there? In some senses, yes, but not in the sense that the GP used 'distant' (i.e., as a objective word for 'not adjacent').

and then it loses all meaning, because a pathogen that can travels within people who travel on planes is a pathogen unconstrained by geography. It was a very odd, and frankly, telling turn of phrase.

Re: Alarming surge in drug-resistant HIV uncovered

#228

Post by malandrew » Fri, Aug 02, 2019, 10:45 PM UTC

rowanG077 wrote: post #226

malandrew wrote: post #225

Earlier quoted context omitted.

Likewise, people who think that no profit should be had for developing medicine don't deserve the medicines that have been developed for profit.

Don't hate the player hate the game. The consumer didn't choose to have greedy companies that like to make a quick bug over someones suffering.

The consumer only exists because of these "greedy companies". You can't consume what doesn't exist.

Re: Alarming surge in drug-resistant HIV uncovered

#229

Post by himlion » Sat, Aug 03, 2019, 1:18 AM UTC

dang wrote: post #68

himlion wrote: post #22

Probably because homosexuality doesn't fit their 19th century worldview

This comment breaks the site guidelines. Would you reviewing them and sticking to them when posting to HN? They include: " Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents. " and " Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good fai…

Sorry Dang, I will refrain from posting this kind of thing in the future.

Re: Alarming surge in drug-resistant HIV uncovered

#230

Post by tripzilch » Sat, Aug 03, 2019, 8:44 AM UTC

malandrew wrote: post #39

dillondoyle wrote: post #35

Earlier quoted context omitted.

I can confirm in the US it is truly that expensive (which is fucking crazy). I have pretty good insurance (or at least the best I can get self-buying) but I still have to pay 30% of meds costs. That is something like $400 /month. Luckily Gilled will reimburse up to 7500 /year. Fucked up private insurance in US, they charge that much and then do the reimbursement so they can bill the huge monthly cost to plans / gover…

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…

Oh look you created an incredibly inefficient, expensive and corrupted system to research drugs and now you claim you spend more on drug research than anybody. Have a pat on the back.