HIV Vaccine

The Sexecutioner writes "WebMD is reporting on a new vaccine which has had an incredible effect in clinical trials. The vaccine, composed of human dendrites holding dead HIV viruses, has dropped test patients' viral load by up to 90% in one year. Could this be it?"

Comments

Re:Mixed feeling

[fupeg]

Simple: the prices in Canada are negotiated by customers who have the time to study the actual costs of production, and who aren't desperately begging for the treatment right now.

This is so completely false that it is not even funny. First off, price ceilings are affected in Canada by its Patented Medicine Prices Review Board. Second, drug distribution is controled by the provinces through each province's list of approved drugs, known as the provincial formulary. If you're not on the formulary, chances are you're not going to be sold in that province. The provicne then negotiates the prices of drugs on the formulary. This has allowed Ontario to freeze the prices on all formulary drugs since 1994. Customers do not negotiate the prices, the government does.

However, the biggest reason drugs are cheaper in Canada is because per capita income is about 20-30% lower in Canada than in the US and there are drug trade barriers between the two markets. If there were no barriers, then the prices would equalize across markets since one could buy a drug in Canada and sell it in the US. But with barriers, drug companies can easily set different prices in different markets, charging their richer customers (US) more than the poorer ones (Canada.) This is a classic monopolist tactic known as differential pricing. Ultimately it is the lower income caused by socialism in Canada and free trade barriers between the countries that cause such a large price disparity.

Re:FDA approval?

[sugar and acid]

Well the real cause for concern with the latest scandal with drugs and the FDA is a fundamental problem of pharmaceutical companies continually trying to reinvent the wheel by making new drugs to treat highly common cronic diseases with treatments that are just as effective already ( eg long term prevention of heart disease, athritis, obesity, depression, sleeping disorders), with often a "me to" approach of producing new drugs that work similary to drugs from another company (notice the explosion in erectile disfunction drugs after the introduction of viagra.

In the case of vioxx, the treatment was designed for anti-inflammatory pain relief in arthritis, by inhibiting an enzyme COX2. It is about as effective as another drug many of us have taken ibuprofen (Advil) for this purpose but instead of being 3-5 bucks for a bottle of 50 to 100 pills, it was sold at ~$2 a pill (it is also how aspirin works to relieve pain as, thus the running joke that the pharmaceutical companies had invented the $2 apirin).

So what was so much better about vioxx that it was developed, FDA approved and prescribed by doctors.

Well it doesn't inhibit another enzyme COX1, like aspirin and ibuprofen do. Inhibiting Cox1 has several effects, the two most important are: the negative effect, gastrointestinal problems like stomach bleeding and ulcers; but it also has a positive effect which is prevention of blood platelet aggregation which prevents blood clots, heart attacks and strokes. This is why aspirin is taken to prevent heart attack, if you take aspirin to prevent heart disease and a specific COX2 inhibitor for arthritis like vioxx together you are really losing the benefit vioxx had over ibuprofen.

Anyway not everyone has a sensitivity to asprin and Ibuprofen, there are estimate that only 8% of those prescribed Vioxx actually got a benefit over cheaper alternatives, but vioxx had a great ad campaign that convinced everybody that they should "ask" (read demand) their doctor to prescribe it, even though it is vastly more expensive. Also the FDA approval could be pushed through because of the "benefit" to those 8% of patients that had gastrointestinal sensitivity to aspirin and ibuprofen.

So what have they found out now- well just inhibiting COX2 by itself actually causes increased blood platelet aggregation and increased risk of heart disease and stroke, this effect is balanced out by the inhibition of COX1 in aspirin and ibuprofen etc. that prevents platelet aggregation.

Now the real issue, Vioxx was pushed out to compete with very cheap, safe and well charactised drugs (so we know all the side effects etc., why do you think you can buy them at the supermarket) due to a very long history of use. Patent it and get it approved for use by the FDA targeting it to one small specific group that have a problem with current treatments to help push the approval through. Once it is approved marketing it to a much wider group of people that are not the specific target group, and will not gain any benefit over a cheaper, better characterised and now known to be safer alternative. To compound the problem the TV advertising of prescription drugs now almost approaching saturation increases this problem by getting the public to demand drugs they don't need.