Comment by alp1n3_eth | Hacker News Reader

Comment by alp1n3_eth | Hacker News Reader

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That's called prescribing off-label, and a lot of moderate to severe IBD patients essentially require it because the recommended dosages (FDA approved) aren't high enough to impact the more severe cases of things like Crohns disease. This decision should be between the doctor and the patient.

The Mayo Clinic runs different trials all the time that involve multiple biologics being used at the same time, AKA "off-label" and they can have great results for the individual. Rinvoq + Skyrizi is a newer combo, but it can be any number of them as different patient's disease can affect them more severely through different pathways.

If a medication combo is approved by a doctor for a patient, and they've even done the worthless dance that is required to try the drugs they already know aren't going to work, then the patient should be allowed it off-label. Especially so if it's proven to be working (lower c-reactive & calpro levels). Tapering off of prednisone in this situation is a massive success. You literally do not know if a biologic will work for a specific case of IBD until it is tried as each patient is different, at the same time these drugs all passed FDA approval and show stats of 40%+ remission after 12-18 weeks.

Also, medication like prednisone can't be prescribed long-term, massive health issues will follow like diabetes and bone density issues (among others highlighted by the article).

Yeah they are great drugs, I will probably be on a similar drug soon.

And of course the patient should be allowed to take it! It just shouldn't be required that the insurer pay for anything at any price.

How would anyone in the US afford a treatment when the system currently supported here inflates prices of these drugs to insane prices? You're defending an inherently corrupt system that leaves the patients in the dark. This isn't supposed to be a market-system, demand is inelastic. They don't have an option to just "go without" life saving medication.

Nothing about this is exotic or an experiment. This isn't some doctor who had a crazy idea he wanted to try, these trials have been run all over the place for 10+ years and show a large amount of success in resistant patients.

The only reason the drugs cost that much is because of how it's designed in the US. Foreign countries (Europe, Australia, England) pay under $1000 per vial / shot for most of these medications, while one shot of a drug like Stelara is $50,000 in the US. Remicade is even cheaper, usually $500 a vial overseas.

The insurance companies want to play this game. They're either in the business of saving lives or they're not, and if they're not, they're actively impeding care to sick individuals. By extension, they are contributing to their deaths if they aren't able to receive the medication they require.

In the US, these pharma companies make multiple billions in revenue from one of these drugs, whereas their overseas sales are in the mid to low millions. It's just the game being played in the US, and there's no reason to let someone die over it. Can't believe someone is actually advocating for this guy, who finally after years found a drug combo that worked, to just die. As there's zero way for an average American to afford 1.2 million dollars a year. Insurance is a risk pool, that's what it's there for.

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