Opinions - Impeding the cure for AIDS?

[BobTheGreat]

Not sure about all countries but in the US we have an arrangement with Africa to provide them with all AIDS meds at cost. This sounds great but drug companies are businesses. Their main goal is to make as much money as possible. Say some researcher comes up with a promising cure/new treatment method. The head of research will most likely skip over it since the government would make them make the new drug at cost. They can then use those facilites to research and manufacture drugs that make them money.

Just wanted to know how other DF members felt about this.

[zera]

Well the business model for drug companies is pretty different from standard manufacturing. It costs pennies on the dollars to make a drug, the vast majority of the cost goes towards research, with a sizeable minority towards marketing. In the scenario you outlined where someone "stumbled" on a cure for HIV, I have little doubt that the company would aggressively pursue it, even the cost of providing the drug at subsidy to Africa would be outweighed by the huge profit potential in the developed world. In fact the most likely cure would in fact be a vaccine, so pretty much all 300 million people in the US would receive it. The cost of developing the new drug is around $10 bn (pretty high), so if they provided the vaccine at cost to everyone but the US, the EU and Japan and charged $200 a vaccine, they're still making around $100 bn even assuming very high distribution, marketing and manufacturing cost.

Not to mention the huge public relations, advertising and good will benefit that the company that cured HIV would reap. Merck completely subsidized the development of a drug to cure river blindness, a disease that only affects very poor sub-Saharran Africans. They got fantastic press off of it, and even today in business schools around the world are held up as a model of a "good corporate citizenry." Could you imagine the intangible benefits from curing HIV?

[BobTheGreat]

Im not saying stumbling across a cure but more of a promising find that still needs a lot a research which like you said is the main cost of new drugs and why genenic companies can produce everything so cheap.

You do bring a good point about public relations but I still think the company losses its ass from the research/clinical trials even if it brings more money in from people buying their drugs when a generic is available since most docs write a script as fillable by generic and pharmacists simple fill the generic.

What mainly made me think of this post was the huge clinic trial of an AIDS vaccine that failed miserable recently.

I cant find the article I read but heres one on the same thing just a bit shorter: http://www.news-medical.net/?id=32457 Googling for the article it also seems that nonprofit organizations are the main researchers. go figure.

[top]Volunteers in AIDS vaccine trial may be at greater risk of infection

Medical Studies/TrialsPublished: Wednesday, 14-Nov-2007

[top]Following the aborting of two international trials of an experimental AIDS vaccine, thousands of volunteers have been told the vaccine may have actually raised their risk of infection.

The trials which were conducted in the United States, Peru, Brazil, Dominican Republic, Haiti, Jamaica, Australia and South Africa, were halted in September after it became clear the vaccine did not prevent infection with the AIDS virus.
It was earlier this month that the researchers revealed there were some worrying indications that the vaccine somehow raised the risk of infection, although they insist the vaccine itself could not cause HIV infection.
Drug company Merck and the research team say they will now "unblind" the study so that all the participants can find out who received the active shot and who received a dummy injection.
The volunteers have already been informed and counselled that they could be at higher risk of HIV, a fatal and incurable virus that causes AIDS and have been encouraged to continue to return to their study sites regularly for ongoing risk reduction counseling and tests.
In order to test vaccines and new drugs, researchers always try to conduct what are called placebo-controlled, double-blinded trials which means in effect that neither the researchers nor the volunteers know who gets a placebo and who gets an active ingredient; this ensures there is no bias in determining the outcomes.
The vaccine researchers are now concerned about the future of their field as well as their volunteers.
The research team from Merck which makes the vaccine, and the National Institute of Allergy and Infectious Diseases believe a type of common cold virus used as the basis of the vaccine may somehow have made their volunteers more susceptible to HIV and still trying to work out how that has happened.
Out of 1,500 people vaccinated, 82 became infected with the AIDS virus, of these, 49 got the vaccine and 33 got a placebo shot; only one woman in the trial became infected with HIV.
The rest were men having sex with other men, and it seems it is the men who initially had the highest immune response to the adenovirus 5 common cold bug used to make the vaccine who were the most likely to become infected with the AIDS virus.
The infected men were also less likely to have been circumcised and may have engaged in more risky behaviour.
So whether the vaccine did actually do something remains a mystery and even vaccine advocates are calling it a setback.
AIDS has already killed 25 million people and affects 40 million more.

[zera]

AIDS is so high profile that I think the pr/prestige would overcome the cost. Remember that managerial incentives are not perfectly aligned with shareholder incentives, so even if it might be bad for shareholders the researchers at a pharmaceutical company may just pursue it anyway for personal ego and career prospects.

I think something that might be more applicable to your original point is antibiotics. Antibiotic resistant bacteria are evolving at a rapid rate. In the US antibiotic resistant staph infections now kill more people than AIDS. And while the deathrate from the latter is falling, the former keeps claiming more lives every year. Yet no new broad-based antibiotics have been brought to market in a while, mainly because the profit potential for lifestyle drugs like Viagra or Zoloft is higher. While someone only needs to take antibiotics for the two weeks after they get sick, the lifestyle drugs they need to buy all the time.

[BobTheGreat]

Originally Posted by zera

AIDS is so high profile that I think the pr/prestige would overcome the cost. Remember that managerial incentives are not perfectly aligned with shareholder incentives, so even if it might be bad for shareholders the researchers at a pharmaceutical company may just pursue it anyway for personal ego and career prospects.

At a shareholders meeting it's pretty hard to convince them to stay with your company if youre researching a drug that could potentially cost billions and has marginal returns at best. I still think the higher ups can the idea. I have the contact info for a head at eli lily so maybe I'll email him to see what he has to say. If he gives the standard nothingness answer I expect I wont bother posting it though.

The antibiotic example is better. At least you got what I was getting at.

[thealmassi1]

The poor ppl in Africa usually can't afford any drugs, never mind the the cure for AIDS. And i doubt most of the ppl with AIDS even know that they are slowly dying in Africa, since i doubt they have money spare to get an HIV/AIDS test. The only solution i see is to give them condoms and teach them to use them. I don't see a bright future for the ppl dying of AIDS over there at all. At least, over here (in Canada) we can prolong our life by decades with drugs. A cure, even with billions of dollars, is far away and may not even be possible, spend the money on sex education is my opinion. But, then again i don't have AIDS.

[BobTheGreat]

Originally Posted by thealmassi1

The poor ppl in Africa usually can't afford any drugs, never mind the the cure for AIDS. And i doubt most of the ppl with AIDS even know that they are slowly dying in Africa, since i doubt they have money spare to get an HIV/AIDS test. The only solution i see is to give them condoms and teach them to use them. I don't see a bright future for the ppl dying of AIDS over there at all. At least, over here (in Canada) we can prolong our life by decades with drugs. A cure, even with billions of dollars, is far away and may not even be possible, spend the money on sex education is my opinion. But, then again i don't have AIDS.

My post although centered around AIDS was never about the actual disease. Like I said the antibotic example was better.

[zera]

Originally Posted by thealmassi1

The poor ppl in Africa usually can't afford any drugs, never mind the the cure for AIDS. And i doubt most of the ppl with AIDS even know that they are slowly dying in Africa, since i doubt they have money spare to get an HIV/AIDS test. The only solution i see is to give them condoms and teach them to use them. I don't see a bright future for the ppl dying of AIDS over there at all. At least, over here (in Canada) we can prolong our life by decades with drugs. A cure, even with billions of dollars, is far away and may not even be possible, spend the money on sex education is my opinion. But, then again i don't have AIDS.

Actually I read an economics study on the issue a few years back. The study found that condom distribution and education saved 10 times as many "life years" as distributing anti-viral cocktails. But by far the most effective was treating other basic STDs, like gonorrhea, with antibiotics.

HIV is actually very hard to transmit from heterosexual sex, which is why it infects heterosexual non-IV drug users at such a small rate in the West. The problem though in Africa is that so many easily treatable STDs that people take care of in the West remain untreated. The presence of open sores on the genitals drastically increases the chance of infection.

[BobTheGreat]

Originally Posted by zera

Actually I read an economics study on the issue a few years back. The study found that condom distribution and education saved 10 times as many "life years" as distributing anti-viral cocktails. But by far the most effective was treating other basic STDs, like gonorrhea, with antibiotics.

HIV is actually very hard to transmit from heterosexual sex, which is why it infects heterosexual non-IV drug users at such a small rate in the West. The problem though in Africa is that so many easily treatable STDs that people take care of in the West remain untreated. The presence of open sores on the genitals drastically increases the chance of infection.

Just to make it known your odds of catching AIDS having unprotected sex with someone infected is ~1/10,000. I believe this is an average. In the absolute worst case senerio it is 1/500 . With a condomn it is 1/5 billion. If you catch it while having protected sex, you should seriously consider playing the lottery.