Saturday, May 12, 2012

Should we pay $11,000 a year to facilitate riskier behavior?

Last week there was news about the possible approval of a drug to treat HIV to now be used to prevent from getting infected in the first place.

The quick answer; this is a great opportunity to prevent the spread of a terrible disease.

The more pragmatic answer; at what cost? Condoms accomplish the same outcome with greater success and cost $30 a month if you're doing very well.

"Other speakers worried that wide scale use of Truvada would divert limited funding from more cost-effective options. Truvada sells for about $900 a month, or just under $11,000 per year. The AIDS Healthcare Foundation, which opposes approval of Truvada, estimates that 20 HIV-positive patients could be treated for the cost of treating one patient with preventive Truvada.

"Truvada for prevention will squeeze already-constrained health care resources that can be better spent on cheaper and more effective prevention therapies," the group states in a petition to the FDA."
That is an additional $10,640 per year per individual. From the same article 1.2 million people have HIV and an additional 240,000 are unaware they carry it. How many of them have partners that will now expect someone else to pay $11,000 per year for them to engage in risky sexual behavior?

1.2 million people times $11,000 is $13.2 billion in additional spending. Around 13 billion more than the more effective condom. Who is going to say no? If you do the left will attack you as anti gay. The government doesn't care, it's not their money and sure to buy some votes. Insurance companies won't care, 15% margin on $11,000 is an extra $1,650 they can make now. Self-funded employers would object but HHS would probably just slap them with another mandate then castigate them for not controlling the cost of insurance. 

A simple solution would be to allow the market to charge more for polices that covered this drug, PPACA pretty much killed that solution. If free birth control is now a right granted by our constitution how can this right also not be "found"?
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