Thursday, July 18, 2024

Why Is Hiv Medicine So Expensive

But How Much Do The Patients Pay

Why is HIV Medication So Expensive? – “Price or Prejudice” – A WRAL Documentary

For those not insured, the US government has agreed to reimburse hospitals for their treatment costs. And the out-of-pocket cost an insured person would have to pay to access this treatment would depend on their insurance provider and policy. Its not uncommon for people to not even know the actual cost of their treatment since they only owe a small copay and the insurance pays for the bulk of it.

And therein lies the problem.

When insurance companies or governments are stepping in to cover costs, this allows for drug manufacturers to overcharge for new drugs and even randomly increase the price of old drugs with little to no notice.

This most famously happened in 2015 with the HIV medication Daraprim, whose cost rose from $13.50 a pill to $750 a pill overnight, causing outrage among patients and politicians. However beyond merely getting infuriated at the price increase, Daraprim is seldom discussed now, 5 years later, and it still costs $750.

Anger towards drug prices is often short lived past the announcement of the price because people still have access to the drugs through insurance or through a cheaper generic alternative.

The disparity between drug prices and what consumers actually pay out-of-pocket for the drug is what keeps Big Pharma setting sky high prices, and increasing them ever so often.

Myrbetriq For Overactive Bladder

Myrbetriq decreases episodes of urinary incontinence in women with overactive bladder as well as, if not better than, Ditropan and Detrol older medications used for the same purpose.

Why fight for it? Patients are more likely to continue taking Myrbetriq because unlike Ditropan and Detrol, it does not cause dry mouth or constipation.

Myth : Prep Use Leads To Riskier Sexual Behavior

Even among PrEP users, there remains a stigma about the medication and those who use it, often manifesting as slut-shaming. PrEP only protects against HIV transmission, so proper condom use is still important to prevent other sexually transmitted infections. But while one Seattle study found sexual behaviors changed after PrEP adoptionincluding a decrease in condom use and an increase in bacterial STIsother studies suggest PrEP does not change sexual behavior.

An increase in STIs could be a result of increased testing , so dont assume it means PrEP users are shifting to riskier sex. In fact, with STI rates rising in general, making a direct link between PrEP and riskier sex seems premature and potentially damaging.

What can be done about it: Regardless of PrEP adoption, regular STI testing and disclosing of results to would-be sex partners need to be normalized.

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Myth : Health Insurance Solves Everything

Ready, Set, PrEP covers uninsured people, and PrEP must be covered by insurance plans under the Affordable Care Act that should make access a nonissue. After all, having health insurance is significantly associated with PrEP use, according to one study. But young people covered by a parents health insurance plan are actually less likely to use PrEP, citing concerns about confidentiality and disclosure and fears of being outed for sexual preference and for being sexually active by an explanation of benefits statement.

What can be done about it:Only 14 states have some protection for dependents that make sure patientsnot policyholderscan be the direct recipients of their insurance statements. Until we can address sex- and HIV-related stigma, more states need to add similar protections, which will improve access to sexual health care for young adults concerned about confidentiality.

Make Best Use Of Adap Benefits

Random Spiritualities from a Doctor

The AIDS Drug Assistance Program has long been considered the first-line resource for HIV medications for low- to middle -income Americans. Since its inception in 1987, the scope of the program has expanded considerably, with some states now integrating medical care, lab tests, insurance assistance, and even HIV preventive therapy into their benefits schedule.

As with other federally funded programs, eligibility is based largely on income, the thresholds of which can vary considerably from state to state. Proof of residency and documentation of HIV status are required.

While most states will limit eligibility to U.S. citizens and documented residents only, some like Massachusetts, New York, and New Mexico have now extended ADAP assistance to undocumented immigrants, as well.

Meanwhile, six U.S. states restrict benefits to individuals or families whose personal net assets fall beneath a specific threshold, ranging from less than $25,000 in New York State to less than $4,500 in Georgia.

The current ADAP income eligibility thresholds are outlined as follows:

ADAP is typically considered a payer of last resort, meaning that, unless you qualify for Medicaid or Medicare, you will need to enroll in some form of private or employer-based insurance.

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How Can People Access Pep

The Canadian PEP guidelines recommend that PEP should be readily available in places where it is likely to be needed urgently. These include emergency departments, sexual health clinics and other clinics serving populations at increased risk of HIV.

The decision to provide PEP lies with the healthcare provider and is made on a case-by-case basis. Many healthcare providers are unaware of non-occupational PEP or may be unwilling to prescribe it. The Canadian guidelines outline practical advice for physicians providing PEP, including how to assess risk in people who present for PEP, how to provide monitoring and follow-up, and recommended drug regimens.

People starting PEP may be offered a starter pack of pills, so that PEP can be started right away, along with a prescription that needs to be filled to receive the full 28-day course of medications. Most emergency departments will have PEP starter packs available.

Anti-HIV drugs are expensive: a month-long course of PEP can cost $900 or more, depending on the drugs used. Although occupational PEP is normally covered by workplace insurance, coverage for non-occupational PEP varies across Canada. Non-occupational PEP medications are covered by some private and public health insurance plans coverage varies depending on the province or territory and the type of exposure.


Discussion And Final Remarks

Before the advent of the new combination drug therapies, most persons with HIV disease waited until their CD4+ cell counts dropped below 200 or until they experienced serious medical conditions before they began antiretroviral therapy. This is not true today. Many believe that antiretroviral drug therapy to arrest the replication of HIV should be undertaken early during the course of illness and should be continued indefinitely to prevent a resurgence of the virus.

The economic consequences of the early and continuous use of expensive antiretroviral therapies by increasing numbers of persons with HIV disease, who previously were not receiving antiretroviral drug therapy, are poorly understood because there are no comprehensive assessments of the cost and financing of care for persons with HIV disease. Yet, the diffusion of costly, new drug therapies among the population of persons with HIV disease in conjunction with the increasing number of persons living with HIV disease indicate that the cumulative cost of treating HIV disease is rising, and that it will continue to do so in the near future.

In order for the special rates for persons with HIV disease to accurately reflect the cost of care, these rates must be based on current data. Rapid changes in the treatment regimens of persons with HIV necessitate that these rates be updated regularly to reflect changes in treatment regimens.

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Hiv Drug Price Increase Brings Price Gouging To The Forefront

Pharmaceutical company Turing came under fire last week after the New York Times reported Turing had raised by about 5,000 percent the price of an old drug used to treat an infection that can be life-threatening in those with HIV or AIDS or with otherwise compromised immune systems.

The founder and CEO of the company, Martin Shkreli, initially defended its decision by saying Turing needed to make the drug profitable and planned to use the profits to make a newer, better drug. After being vilified in the press, however, Shkreli said on September 23 that Turing would lower the cost of Daraprim, though he did not say by how much. The controversy gave both medical professionals and politicians an opportunity to discuss the rising prices for drugs that treat myriad conditions.

Daraprim was approved by the Food and Drug Administration in 1953 to treat toxoplasmosis, a parasitic infection that can come from eating undercooked meat or unwashed fruits and vegetables. It can also be contracted from cat feces when cleaning litter boxes. The parasite is common and most people never get symptoms, but it can be very dangerous to pregnant women and those with compromised immune systems, such as the elderly, infants, certain cancer patients, and people with HIV or AIDS.

Covid Costs: Why Is Remdesivir So Expensive In The Us

Here’s Why Drug Prices in the U.S. Are So High

Gileads COVID-19 Treatment Remdesivir is priced at $354 in India, but $3,120 in the US.

There was some controversy surrounding the California-based pharmaceutical company Gileads recent reveal of its intended prices for Remdesivir, an antiviral medication approved for emergency use on COVID-19 patients.

High drug prices have long been a source of contention among politicians and consumers alike in the US, who believe Big Pharma the large pharmaceutical corporations generally operate in a sinister way that goes against public good and is rather driven solely by profits.

Gilead announced that Remdesivir would be sold to developed countries governments for $390 a vial which means the standard treatment cost would be $2,340 for five days . They also announced a partnership with producers in 127 lower-income countries so that they can make a generic version of the drug at a lower cost during the pandemic. Drugmakers in India have announced that their price would be no more than $66 a vial, with some suggesting $59 a vial, making the total treatment cost available for as low as $354.

That price may seem shockingly high, but independent analysts expected the total treatment cost to be in the $4,000 region.

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High Costs: A Case Study In Drug Pricing

Activists and lawmakers often point to the high cost of PrEP as a key reason for its low use. In 2012, Gilead set the price for Truvada as PrEP at more than $14,000 per year, and it is now more than $22,000.

Gilead has made $19.5 billion on Truvada since 2012 , but many consumers pay little to nothing for the drug. Medicare, Medicaid and private insurers pick up much of the cost, and Gileads copay assistance program has helped many people with private insurance cover deductibles and other out-of-pocket costs. People without insurance can access free PrEP from Gilead or the federal government.

There is no broad-based evidence linking the price of PrEP to low uptake, but smallsurveys and anecdotal evidence indicate the drugs cost has prevented some people from accessing or continuing to use PrEP.

Below are several common pharmaceutical industry practices used to maintain high prices and how Gilead employed them in the case of Truvada.

This Is Why Hepatitis C Drugs Are So Expensive

Earlier this week, actress Pamela Anderson announced that she’s been cured of hepatitis C. She shared the news in a joyful Instagram post that proclaimed, “I am CURED, but also acknowledged that the treatment she underwent is out of reach for many Americans.

“I pray anyone living with hep C can qualify or afford treatment, she wrote. “It will be more available soon. I know treatment is hard to get still”

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Truvada Has Been Called The ‘miracle’ Hiv Pill So Why Is Uptake So Slow

It has been approved by the FDA and endorsed by the World Health Organization as safe and effective in preventing HIV, so why is there so much pushback to this so-called miracle drug?

Across San Franciscos hilly streets, rainbow flags are always present, shining through the citys persistent fog, displayed outside the citys trademark brightly colored Victorian homes and their modern apartments packed with Silicon Valley millionaires. And now this longtime home to gay pride and technological innovation may soon become the countrys leader in the fight to eradicate Aids.

This week, city supervisor David Campos unveiled a radical plan with a single goal: to wipe out HIV in the city. The plans could rest on what some have described as an HIV miracle drug and others have described as a public health disaster in the making: Truvada.

The drug, if taken every day, has a remarkable record in preventing HIV infection, and some believe its as effective as condoms. Campos has introduced a proposal that would make it available to any San Franciscan male, female or transgender who could benefit from it. This effort is backed by fellow supervisor Scott Wiener, who on Wednesday announced that he takes Truvada.

It can cost between $8,000 and $14,000 per year, though the manufacturing company Gilead offers payment plans for those who cant get it through insurance.

High Hurdles To Get Daraprim Cheaply

Why are some generic drugs getting so expensive?

Turing has made a big deal about programs it has created to reduce the costs for patients. For instance, it says that the drug is available for free to people with deep financial need.

But Dr. Aberg has watched her patients have to “jump through the hoops” to get it. Patients have to prove both financial need and health status, something that’s difficult to focus on when their lives are in danger. In June, one of her patients gave up on the process. The patient switched therapies, only to suffer a negative side effect.

The application also requires patients to sign broad disclosures “to use and disclose all of my individually identifiable health information.” Dr. Aberg says some patients, especially with HIV and AIDS, are hesitant to do that.

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Why Is Hepatitis C Medicine So Expensive

Critics point out that chemically, an entire 12-week regimen of Sovaldi only costs $136 to manufacture.

But a common refrain from pharmaceutical companies is that the high cost of research and development, along with the financial risks of developing a new medication without the guarantee of government approval, are the two biggest factors for high price tags on drugs. Firms that have risked millions to develop and test a drug in large-scale trials want to recoup that investment, and then some. For instance, Gilead Sciences, which manufactures Sovaldi, spent $11 billion in 2011 to acquire Pharmasset Inc., the pharmaceutical company that invented the drug in the first place.

The second factor in the drugs cost is the calculated value of the regimen to a patient. Dr. Nancy Reau, a liver disease expert and a paid consultant for pharmaceutical companies that make hepatitis C medications, argues that the price of a hepatitis cure is “priceless” and still cheaper than the alternative: a lifetime of liver complications.

In a 2014 article for the journal Hepatology, she wrote that hepatitis C treatment has never been cheap — the older medications also cost around $172,889 to $188,859 for each patient who was eventually cured. Those prices factor in the costs of managing the considerable complications that arose from the old-generation hep C drugs, their low cure rates, and the costs of relapse.

Changes Due To The Affordable Care Act

The Affordable Care Act was signed into law by then-president Barack Obama in 2010. The ACA provides for several changes that can dramatically improve the health of people living with HIV by increasing their access to health care. For example, it stops insurers from denying coverage to those with pre-existing conditions and stops insurers from putting lifetime or annual spending limits on insurance benefits, which often affect those living with long-term conditions like HIV. The ACA has also increased women’s coverage for reproductive health care .

The ACA creates health insurance marketplaces for people to buy affordable health insurance if they do not have access to insurance through their employer. It also provides for changes to many programs that already help people living with HIV get their HIV drugs, like Medicaid and Medicare.

It is important to note that, as of this writing, the ACA is still in effect, despite high-profile attacks on the law by some right-wing lawmakers and former US President Trump. At the end of 2017, Republican lawmakers eliminated the ACAs requirement that nearly all individuals have health insurance or else pay a fine, commonly known as the individual mandate. Meanwhile, COVID-19 relief bills have expanded short-term eligibility for some people. The ACA itself is still very much alive, but specific provisions may change.

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Whats The Deal With Gilead Sciences

Okay, Seinfeld. Gilead Sciences is a pharmaceutical company based in California with a bit of a reputation. Most recently, in 2020, Gilead Sciences filed for Orphan Drug status of the experimental COVID-19 treatment remdesivir. The company relinquished this designation after the public rightfully vilified the company.

In other news, Gilead Sciences is currently embroiled in a legal battle with the U.S.Centers for Disease Control and Prevention over patents for the HIV prevention drug Truvada, a form of pre-exposure prophylaxis . The gist of the legal battle is this: Gilead claims it lent compounds for Truvada to the CDC for research purposes, and the CDC allegedly signed a contract promising to notify Gilead if the department applied for any patents related to the resultant research. In November of 2019, the HHS sued Gilead for damages, claiming that the company infringed on HHS patents for Truvada and Descovy, another HIV drug. A press release from the HHS reads as follows:

In the complaint, HHS alleges that Gilead has willfully and deliberatively induced infringement of the HHS patents. The complaint further alleges that, as a result of such infringement, Gilead has profited from research funded by hundreds of millions of taxpayer dollars and reaped billions from PrEP through the sale of Truvada® and Descovy®.

Effectively, HHS is stating that the government owns the patents for these drugs, as the government did the research for them.

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