How to save a life, Superman style
Good news – there is now a twice-a-year injectable drug that prevents a person from getting HIV/AIDS even if they are exposed to it. With drugs like this, eradicating HIV is more possible than ever.
Now for the bad news – each injection costs $14,000. (Thud.)
First, let’s applaud the scientists who made this drug. In the 1980s, there were no treatments for HIV/AIDS and nearly 60% died of the disease. When Highly Active Antiretroviral Therapy (HAART) hit the market in the late 1990s, a new phrase had to be invented – “people living with HIV” – because people were surviving it.
Nowadays, people living with HIV who religiously take anti-retroviral drugs can live healthy lives and not spread the infection to others.
Yet this new injectable drug has a side effect, not on the people who take it (though that may happen too), but on everyone else, even people who know no one with the disease.
Picture the miracle drug as Superman and people living with HIV as Lois Lane. Superman does miraculous things to save her, even turns back time. (See the movie clip. Whatever you’ve got to do, it can wait for four minutes!) Likewise, the high-tech drug miraculously snatches people from the jaws of death. Unlike a superhero, the drug leaves a trail behind it – the cost. I picture it as a shower of fine dust that lands on every person, every company, every community.
The cost makes a tiny difference in the cost of everyone’s health insurance, which makes a tiny bump in property taxes since schools pay for health insurance, which makes a tiny bump in housing costs, which makes a tiny shift in how people spend their money, and so on. The drug’s cost, like the cost of all medical care, ripples through the entire economy in this way.
People and organizations who have money do not notice one more tiny burden. They point to the Lois Lanes saved and they fret about anything that could stymie progress on the next superpower drug.
There are hundreds of super drugs, each adding their tiny cost trail behind. Prescription drugs cost $2,157 per person (man/woman/nonbinary/ child) per year in 2023. Eighty dollars of that was for new drugs. Eighty dollars might not seem like much, but new drugs are not the only thing pushing medical costs higher – think of high-tech inventions like gene therapy and lower tech necessities like paying staff.
Here is the root problem: we can see the Lois Lanes and hear their exciting, triumphant stories. We can’t see the millions of people who cannot get primary care, cannot get basic medications (let alone fancy, high-cost ones), cannot afford health insurance – these people all die younger partly because they are shut out of health care, partly because the “haves” get a little further away from the “have nots” with every medical miracle and the “tiny” burdens they create.
This is why the United States spends twice as much on medical care and has lower life expectancy compared to other developed countries. Other countries have struck a different balance in spending on basic life-saving goods and on superpower medical care or drugs – that’s the main reason they live longer on average.
Some will gasp and demand, “So you think we should STOP making wonderful drugs and treatments that save lives?????”, as if the answer is completely obvious. That is exactly the point – the answer is not completely obvious. We save some lives with superpower drugs and we shorten other lives because of the drugs’ cost. The question is whether we recognize these tradeoffs and willingly make them.
