TRUVADA IS AN extraordinary drug. Take one a day, and the chance of contracting HIV is reduced by up to 99%. Even without a cure for the disease, if all people at high risk of contracting it took the prophylactic pill, hiv would eventually be snuffed out. But a big problem is cost. There are 1.1m Americans, mainly gay and bisexual men, who should be on the pill, according to the Centres for Disease Control. In fact only 200,000 are taking it. A course of treatment costs $2,000 per month-nearly 45% higher than in 2013. In Britain generic versions of the pills available online mean the same treatment costs just £45 ($58). Such exceptional disparities in drug prices are typical in America. Pharmaceutical spending is the highest in the oecd club of mostly rich countries, at $1,174 per person-more than twice as much as in Britain. Voters have grown tired of the price-gouging. Over the past five years, prices of the 20 most-prescribed brand-name drugs have rocketed at ten times the rate of inflation. Out-of-pocket costs, the cash payments made for treatment that are not covered by health-insurance premiums, have spiked. For these reasons, health care has been the subject of nearly half of all political advertisements on television in the run-up to the mid-terms.
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