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Drug Companies and HIV Treatments

Feb 18, 2005

Hi Doctors.

As a recently diagnosed HIV positive person, I have been doing a lot of thinking lately. (Surprise, surprise!!)

I would like your opinion about the drug companies and HIV medication.

Obviously, drug companies make a lot of money out of HIV medications. The cynical side of me has thoughts that perhaps a cure for HIV might "never" be found in order that the drug companies can keep making money on medications they currently sell.

That is, if a cure is found one day, once people have had that shot, or taken that pill... then that's it! No more drugs. I know this might seem very cynical and/or incredibly simplistic, but what's your take on the situation. Just how ethical and moral are the drug companies?

Finally, do you ever think we'll find a cure for this nemesis? Why is it so hard??

Thanks for your time and wonderful website.

Response from Dr. Pierone

The drug companies are as ethical and moral as the rest of humanity so they are sometimes ethical and moral, and other times not.

Is the cure for HIV going to come from a traditional drug company? Probably not, their primary business is drug discovery followed by scientific studies of safety and effectiveness for human disease. Once they complete this process the marketing arm of the company takes over and "sells like hell". Not uncommonly, a newer and better agent is brought forth by a competing drug company. Does this event inspire an attack of ethical and moral behavior? Does it prompt them to contact physicians and inform them that a new drug is available that has been proven to be superior to their own agent? Usually not (actually never) - they will promote and flog their old horse drug until they have squeezed the last dollar out of it.

How do they sell older, less effective agents? To accomplish this goal, they depend on a fresh faced sales force to extol the benefits of their stolid, proven, and dependable old drug. The old grey mare ain't what she used to be, but hey doc, at least you know what you are getting. This new filly may be fast, but does she have a 15 year history of proven ability to win races? It can't be happy work to go in and try to sell doctors on using an agent that is past its prime (but someone has to do it, I suppose).

Do the pharmaceutical companies have covert teams to delay, prevent, or conceal cures for AIDS or cancer? No. But the cure or startling breakthrough in HIV is likely to come from a separate and distinct industry biotechnology. The next leap forward could be based on gene therapy, cellular therapy (like stem cells), or immune based techniques. In fact, the first successful proof of concept therapeutic vaccine trial (with dendritic cells) was recently reported.

Hopefully we will hear of some exciting new approaches at the Retrovirus conference in Boston next week. Thanks for posting!

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