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Mar 30, 2002


this may sound slightly cynical, but I have to ask. Do doctors ever consider treatments based on their costs and 'tailor solutions' based on the patients ability to pay? I am wondering because I live in a country where all HIV meds are fully subsidised and literally have a smorgasbord of with government putting pressure on doctors via mangement to save which meds then would first spring to mind for starting treatment regardless of cost, insurance etc etc..

Response from Dr. Young

Thank you for your question.

In general terms, I don't tailor my recommendations for HIV treatments on the basis of cost. I try to pick the best medications (based on effectiveness, tolerability and side effect profile) for an individual person-- as such, I am playing the role as my patient's advocate. The same may not be true, however, if one is in the role of advocating for communities, from a public health-financial perspective-- here, issues related to the cost of healthcare play important roles in the decision to use a medication or health intervention (say, for example, a lab test).

I say this with full understanding that in the United States, we are very fortunate to have excellent financial access to medications; this same situation is saddly, not uniformly true. Other issues, such as the actual cost to the patient do come into the decision process. Here, we try to make sure that the patient has access to all financial assistance programs (governmental, non-governmental and pharmaceutical) prior to starting therapy) whenever possible. BY

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