> Maybe I’m missing something, but discussions on the cost of medicine never seem to question whether using prescription drugs is the right choice to begin with.

Because it's pretty darn obvious that once you have Hep C, yes, prescription drugs are the right choice. No one's pumping Hep C drugs into people who don't have Hep C.

> Surely the solution to this epidemic is to address the underlying drug problems first?

I'd recommend addressing both problems at the same time. There's no reason we can only do one.

Limited people, time, and resources are why you can't do both at the same time. Developing one solution impedes the development of another

> No one's pumping Hep C drugs into people who don't have Hep C

However, that is what is being done with HIV drugs under the guise of PrEP

https://en.wikipedia.org/wiki/Pre-exposure_prophylaxis

So I wouldn't be so quick to rule it out, specially if Pharma companies see a way to profit out of it.

> Under the guise of

I thought y'all were all about prevention? Now you're acting like preventing acquisition of a lifetime disease is a bad thing.

Prevention is great, and I'm certainly a big fan of it...

but by overexposing people to the drugs that are actually effective against HIV we're both helping the virus evolve around them and having to deal with whatever adverse side effects the drugs have on healthy patients.

Yes, but to address rampant drug abuse- especially the kind where users are sharing needles-, you'd have to address a host of systemic social problems, poverty foremost amongst them. I agree that's a great idea, but also one that's not in the interests of the pressure groups keeping pharmaceuticals expensive either.

Just in case anyone still needs a source for this kind of thing, here's an example: https://www.webmd.com/mental-health/addiction/news/20180326/...

You may be interested in this: https://news.ycombinator.com/item?id=19328202

Apparently the mortality rate from ICD-10 X44 (stuff like blood pressure medication, antibiotics, etc) causes has risen more than 5x over the last 20 years. It seems these deaths are getting grouped in with X42 (heroin, cocaine, etc) in all the reports we hear about.

http://apps.who.int/classifications/apps/icd/icd10online2004...

Actually an easier solution is providing free needles. No massive society has ever been drug-free AFAIK.

This worked out exceptionally well in my native Portugal. Specially when combined with decriminalization of all drugs.

https://www.economist.com/europe/2009/08/27/treating-not-pun...

If you treat the drug problem without addressing the cost of the treatment, you may end up doing too good a job. The Hep C treatment could become less profitable for drug companies, driving prices up for the (smaller number of) people who still get Hep C.

You need to address both issues. By your own admission, "Hep C kills more people in the United States than all other infectious diseases combined." It would be outright unethical to do nothing to address treatment for people who already have the disease. And besides, sharing needles doesn't cause Hep C infections: sharing needles with someone with Hep C does.

Addressing the underlying problem is orders of magnitude more difficult. That doesn't mean we shouldn't try (and we already are trying), but saying "just fix the root cause" isn't actually a helpful suggestion.

Drugs are not the last resort. Amputation of infected limbs was once a common treatment for infection. So too blood transfusions. Drugs are now used instead. That is a good thing.

> Surely the solution to this epidemic is to address the underlying drug problems first?

Try this scenario out for size: Tomorrow you go shopping, while leaving the shop, a teenager enters with a gun demanding money, he gets nervous and shoots the cashier and while running out the store shoots you in the leg. Luckily authorities are quickly at the scene, arrest the criminal, and medical personal take the clerks body away. A cop comes by you and says: Geesh, that sure looks bad, but don’t worry, we are hard at work trying to solve the youth criminal behavior at the root of your current condition. And don’t worry after you bleed to death the medics will be able to fit you in the same van as the clerk, so you won’t be that big of a bother for them. Sad though to think, before we started focusing solely on root cause issues, they could have just stopped your bleeding and taken you to the hospital. But I hope you understand, it’s about efficient allocation of resources.

You didn’t read the entire second half of my comment.

> Surely the solution to this epidemic is to address the underlying drug problems first?

If we were gods who could "address" any problem we wish by pure will power, that would make perfect sense.

For mere humans, some problems are much harder than others, and it's best to focus efforts on the solvable ones.

Not that it’s particularly effective but we do have a “War on Drugs”.

The reality is that both are worth pursuing. Prevention may get better with something like improved access to clean needles. But people will still have Hep C and it’s not just nice to try and help them, it’s economical to do so.

> but we do have a “War on Drugs”.

Which is not more than a scam by now.

Wikipedia has a nice section on the efficacy of this war: https://en.wikipedia.org/wiki/War_on_drugs#Efficacy_of_the_U...

You overestimate the willingness of people to save their own life by not smoking, eating healthy, exercising etc.

i dont think that eating too many cheeseburgers is very similar to being a user of insanely addictive intravenous drugs...

do you think that "just stop injecting heroin" is actually all it takes?

You have to look at the numbers (I haven't, just think hamburgers are more harmful).

I think doctors to want patients to exercise & stuff, but patients don't (ex: diabetes).