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Author Topic: Kaiser - Replacing Epzcom for generics  (Read 21272 times)

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Offline bocker3

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Re: Kaiser - Replacing Epzcom for generics
« Reply #50 on: October 25, 2012, 07:34:12 am »
unbelievable....

I pay over 10k per year and suppose to settle for whatever the system wants just to save them some money and with "PEOPLE LIKE YOU" support....

that's the reason why the USA is behind in many things, too many sheep afraid to defend their real rights and afraid of the big ones. There's nobody paying anything for me at all.. otherwise, there's plenty of wealthy people getting treatment and pills for free around. I feel sorry for people afraid to fight getting upset for the ones that obtain what they deserve for doing so.  Good lucky to you guys

What "rights" exactly are you talking about here?  The right for others in your insurance company to subsidize your care?  Yes -- that is what insurance is supposed to do -- some use more than they pay in and some use less.  Again -- our system isn't ideal, but you can't pretend that it is something that it is not.
As for "nobody paying anything for you" -- that is sheer and utter BULLSHIT.  You ARE being subsidized by other Kaiser members.

So -- it is PEOPLE LIKE YOU that are the problem -- you want the best of everything (even when not warranted, medically) AND you want someone else to pay for it.

Mike

Offline eric48

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Re: Kaiser - Replacing Epzcom for generics
« Reply #51 on: October 26, 2012, 05:45:19 pm »
The expense reductions could be invested directly into research.

Is there is in this world a single major politician who has turned your well wishing suggestion into a committing proposal ?

Is there a single big budget or big pocket decider who has ever offered to buy back a Big Pharma's patent to make it public domain faster ?

Any candidate to propose that gvt should compensate Merck today to make RAL (raltegravir)  available as a generic as early as tomorrow?

Is drug treatment and cost any different than a pole tax on HIVERs, that eventually makes them (us) economically more challenged and demographically confined in 'minorities'

Big Pharma and insurance companies are part of the system, accomplices, but they are not the deciders

If EFV going generic can save as much as one billion dollars to the victims of HIV why does the gvt(s) not bail out patent owners (for, say, 500 millions) and save the health system?

If the health system is on the verge of bankcruptcy, why not cut the franchise duration ? Even at the expense of properly compensating Big Pharma so that they can use this sudden cash towards growing threats like Hep C?

My concern is that the historical treatment pathways (PIs, NRTIS, NNRTIs) will become anchored as the sole available treatment for the only reason that they were historically the first. As if the science of understanding the virus in depth had made no progress in the last 20 years?

The only way Big Pharma can extend its franchise is by coming with new drugs that make older drugs obsolete. And the best way to make older drugs obsolete is to make the virus more resistant with inconsiderate missusage of patent expired drugs.

With Truvada becoming an OTC drugs, who long do you think it will take to see viruses resistant to that entire class?
Now since when is Truvada an OTC ? Since anyone can go to their doctor, claims that the are in a magnetic relationship, buy their Prep for $800/month and resale it on black market for $1200/month and messing with dosage.
 
The expense reductions could be invested directly into research.

Agreed by HIVERs.

Approved by HIVERs.

but dismissed with applause by unconcerned bystanders

I still liked it better when R&D was made in high tech furbished Baltimore or Caltech. Now it is moving to 'emerging' R&D' centers in Swaziland or Shanghai (no discrimination intended)...

Eric

 
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline madbrain

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Re: Kaiser - Replacing Epzcom for generics
« Reply #52 on: October 26, 2012, 06:53:46 pm »
Is there is in this world a single major politician who has turned your well wishing suggestion into a committing proposal ?

No, but very few useful HIV meds have gone off-patent at this point in time. The savings for insurance companies and governments are still many years away.

Quote
Is there a single big budget or big pocket decider who has ever offered to buy back a Big Pharma's patent to make it public domain faster ?

Any candidate to propose that gvt should compensate Merck today to make RAL (raltegravir)  available as a generic as early as tomorrow?

That is a completely different topic. I only suggested that after the meds go off-patent, governments continue spending the same amount of money that they already spend into programs like ADAP, but invest the money into research instead of reducing the HIV/AIDS related spending. I did not say that this would happen overnight.

Quote
Is drug treatment and cost any different than a pole tax on HIVERs, that eventually makes them (us) economically more challenged and demographically confined in 'minorities'

I don't follow you at all.

Quote
Big Pharma and insurance companies are part of the system, accomplices, but they are not the deciders

They have bought enough of the congress that they effectively decide. Our government won't even bargain for drug prices.

Quote
If EFV going generic can save as much as one billion dollars to the victims of HIV why does the gvt(s) not bail out patent owners (for, say, 500 millions) and save the health system?

If the health system is on the verge of bankcruptcy, why not cut the franchise duration ? Even at the expense of properly compensating Big Pharma so that they can use this sudden cash towards growing threats like Hep C?

I think your premises are wrong, so the solutions you propose do not follow.

Quote
My concern is that the historical treatment pathways (PIs, NRTIS, NNRTIs) will become anchored as the sole available treatment for the only reason that they were historically the first. As if the science of understanding the virus in depth had made no progress in the last 20 years?

Oh come on now ! 20 years ago was 1992, there were no known working treatments, combination therapy was not there yet. Plenty of progress has been made since.  The list of classes of drugs is much longer than what you say.
See http://en.wikipedia.org/wiki/Antiretroviral_drugs#Classes_of_drugs

Quote
The only way Big Pharma can extend its franchise is by coming with new drugs that make older drugs obsolete. And the best way to make older drugs obsolete is to make the virus more resistant with inconsiderate missusage of patent expired drugs.

This is extremely cynical. I completely disagree this is the best way. They can make older drugs obsolete by having better treatments with fewer side effects, and perhaps longer lasting in the body which would allow treatments to be less frequent instead of once a day. I am not bothered by it but I know many people don't like to take pills daily. If I want to visit an unfriendly country for 2 weeks and I don't have to take my HIV meds and incur the risk of being sent back, that's a big plus.

Quote
With Truvada becoming an OTC drugs, who long do you think it will take to see viruses resistant to that entire class?

Truvada is not becoming an OTC drug, so once again your premise is wrong.

Quote
Now since when is Truvada an OTC ? Since anyone can go to their doctor, claims that the are in a magnetic relationship, buy their Prep for $800/month and resale it on black market for $1200/month and messing with dosage.

That is not my definition of an OTC drug. The resale of the drug would be a felony.

I agree there are issues with Truvada PrEP and resistance, and I hope doctors are not hasty prescribing the drug, and patients on PrEP get the required followup. This has nothing to do with the issue of generics vs brand name.

Offline leatherman

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Re: Kaiser - Replacing Epzcom for generics
« Reply #53 on: October 26, 2012, 07:23:36 pm »
They have bought enough of the congress that they effectively decide. Our government won't even bargain for drug prices.
Untrue. The Ryan White Fund and Medicaid negotiate on State and Federal levels for lower drug prices all the time. RW, in particular. has negotiated within the last two years for million of dollars off the regular prices allowing a huge clearing of the ADAP waiting lists back in the Spring.

That premise (of negotiation) is why the Single Payer Method has proof of working by how Medicaid and ADAP pay less for medications. ;)
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline madbrain

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Re: Kaiser - Replacing Epzcom for generics
« Reply #54 on: October 26, 2012, 07:36:39 pm »
leatherman,

Untrue. The Ryan White Fund and Medicaid negotiate on State and Federal levels for lower drug prices all the time. RW, in particular. has negotiated within the last two years for million of dollars off the regular prices allowing a huge clearing of the ADAP waiting lists back in the Spring.

That premise (of negotiation) is why the Single Payer Method has proof of working by how Medicaid and ADAP pay less for medications. ;)

Thanks for correcting me, I didn't know Ryan White and Medicaid did that. I know Medicare part D does not.

As for the Single Payer Method, it has worked in so many other countries, the proof that it works was provided a long time ago.

Offline eric48

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Re: Kaiser - Replacing Epzcom for generics
« Reply #55 on: October 27, 2012, 01:47:12 am »
That is not my definition of an OTC drug.

Wait until you see Truvada as easy to find as illegal drugs in the US , just asking some fellow around the corner

So not over the counter, but Off The Corner.

It would be interesting to learn if generics availability can be linked to an increase in resistance. I'll check the available lit. what what they say about countries such as South Africa or neighbouring countries

Eric
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline MitchMiller

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Re: Kaiser - Replacing Epzcom for generics
« Reply #56 on: October 27, 2012, 03:12:24 am »
BugInMe:   I agree with your statement:  Incentive is the #1 driver of innovation and discovery.  The anti-viral pipeline is coming to an end.  As more and more drugs come off patent the financial incentive for new drug discovery will dry up.  This is not unique to antivirals.

However, I take a different perspective.  HIV has a LOT of room to improve treatment beyond antivirals.  I see the anti-viral pipeline as a disincentive to bring forth the next generation of HIV drugs.  Once the anti-virals are all generic, a new generation of HIV drugs has the potential to render them obsolete.  Given the knowledge being acquired about HIV, I don't see HIV drug research going the way of antibiotics.

Offline eric48

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Re: Kaiser - Replacing Epzcom for generics
« Reply #57 on: October 27, 2012, 08:44:48 pm »
So one working at big Pharma told me a double blinded full fledged clinical trial costs around 800 million US Dollars.

I hope they can reduce that cost with 'generic' clinical trials ;-)

ERic
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline madbrain

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Re: Kaiser - Replacing Epzcom for generics
« Reply #58 on: October 28, 2012, 01:37:12 am »
Wait until you see Truvada as easy to find as illegal drugs in the US , just asking some fellow around the corner

So not over the counter, but Off The Corner.

In other words, BS. By your definition, any drug is OTC since people who have prescriptions could choose not to take them and sell them illegally. I still don't see a point.

Quote
It would be interesting to learn if generics availability can be linked to an increase in resistance. I'll check the available lit. what what they say about countries such as South Africa or neighbouring countries

It doesn't even seem interesting to research. You are mixing up generics and OTC drugs.
HIV drugs, whether generic or brand name, are still by prescription only here, and I don't think it's any different in South Africa.

Offline madbrain

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Re: Kaiser - Replacing Epzcom for generics
« Reply #59 on: October 28, 2012, 01:43:53 am »
So one working at big Pharma told me a double blinded full fledged clinical trial costs around 800 million US Dollars.

I hope they can reduce that cost with 'generic' clinical trials ;-)

B.S. again, one clinical trial does not cost anywhere near that much.
Go to http://www.clinicaltrials.gov/ . First line says that there are 134,739 studies in progress.

$800 million x 134,739 is $107.79 trillions.
The entire US GDP is "only" about $15 trillions.

Offline eric48

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NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline eric48

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Re: Kaiser - Replacing Epzcom for generics
« Reply #61 on: October 28, 2012, 06:53:07 pm »
estimate of cost for phase 3 trial for approval of Quad:

number of participants: 708
source
http://www.retroconference.org/2012b/Abstracts/43391.htm

cost per patient: 40 k
source
http://www.marketwire.com/press-release/per-patient-clinical-trial-costs-rise-70-in-three-years-1538269.htm

that is already 28 million USD for one trial

multiply by around 3 to take into account phase 1, 2 and 4 this is ca. 100 million

not to mention the trials for each individual component (elvitegravir and cobicistat)

Hope this helps

Eric

PS: this is of interest to:
http://hivdb.stanford.edu/surveillance/map/
« Last Edit: October 28, 2012, 07:02:41 pm by eric48 »
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline madbrain

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Re: Kaiser - Replacing Epzcom for generics
« Reply #62 on: October 29, 2012, 02:54:23 am »

Offline madbrain

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Re: Kaiser - Replacing Epzcom for generics
« Reply #63 on: October 29, 2012, 02:57:23 am »
estimate of cost for phase 3 trial for approval of Quad:

number of participants: 708
source
http://www.retroconference.org/2012b/Abstracts/43391.htm

cost per patient: 40 k
source
http://www.marketwire.com/press-release/per-patient-clinical-trial-costs-rise-70-in-three-years-1538269.htm

that is already 28 million USD for one trial


Right, 28 million, not 800 millions .

Quote
PS: this is of interest to:
http://hivdb.stanford.edu/surveillance/map/

Of interest, yes.
But irrelevant to the issue of generics vs brand name drugs.

 


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