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Protease inhibitor funding in New Zealand
Jan 16, 1997

The NZ government is currently holding off making protease inhibitors available to people with HIV. They claim that the drugs merely stave off the onset of Aids and death, rather than providing any sort of long-term benefit. What evidence would you cite that would help us to challenge this position? Thanks for your help.

Response from Dr. Cohen

I don't want to get into a fight with the government of New Zealand, as it's a place I very much hope to visit someday. I will just make a few comments:

Protease inhibitors have been shown to decrease the complications associated with HIV infection and to improve quality-of-life.

Protease inhibitors have been shown to be cost-effective in several studies because they prevent hospitalization and the need for treatment of HIV-related complications. They have also been shown to be MORE cost-effective (in terms of cost per year of life saved) than a large number of medical interventions that we all take for granted, such as coronary artery bypass grafts in elderly patients, renal dialysis, and yearly screening mammograms.

Protease inhibitors may reduce HIV transmission by lowering viral loads and making people less infective.

There is hypothetical evidence that the benefit of protease inhibitors may last indefinitely (permanently?) in some patients, and the possibility of cure has been raised.

Finally, what's wrong with "merely" staving off the onset of AIDS and death. Isn't that the point? It sounds pretty damn good to me (and probably to a lot of my readers!)



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