Errrm, it's my understanding that "compliance", i.e. people actually taking their prescribed medicines per schedule, is a terrific problem in the real world. The payoff in patient health can be substantial; in one area I'm familiar with, anti-depressants, there's a strong bias towards those that are normally taken once a day (one of the many advantages of Prozac, the first SSRI).
So I can see lots of physicians routinely prescribing the valacyclovir ... although for someone like me, to whom the whole idea of compliance was a new, almost unthinkable thing when I first learned about it, they'd like go with the acyclovir (especially after I looked up the drugs in question, read up on their pharmacokinetics, etc.; obviously I'm a special case, e.g. nowadays I tell my doctors what to prescribe me for allergies and sinus infections, having learned what works and what's cheap).
Hmmm, come to think of it, when I got an "early" (age early 40s) case of herpes zoster (shingles, and, yeah, it's no fun at all, get the vaccine when you can) in 2003 I was prescribed acyclovir, by a doctor who knew both my financial situation (not great then) and compliance patterns.
Yeah, I don't mean to diminish the importance of compliance -- it's a big problem, especially for things like antibiotics and anti-viral meds. And certainly, three times a day is a lot easier than five times a day. But as you imply, you might rationally make a different choice if you (the patient) know the facts. My point is that nobody has any skin in the game in the current system -- from the perspective of the decision makers, the costs are almost totally externalized.
Aside: I also learned about this when I came down with shingles. That was a bummer (not the least of which because I was on COBRA at the time, and the insurance company refused to pay the med costs without going through a complicated reimbursement scheme!)
So I can see lots of physicians routinely prescribing the valacyclovir ... although for someone like me, to whom the whole idea of compliance was a new, almost unthinkable thing when I first learned about it, they'd like go with the acyclovir (especially after I looked up the drugs in question, read up on their pharmacokinetics, etc.; obviously I'm a special case, e.g. nowadays I tell my doctors what to prescribe me for allergies and sinus infections, having learned what works and what's cheap).
Hmmm, come to think of it, when I got an "early" (age early 40s) case of herpes zoster (shingles, and, yeah, it's no fun at all, get the vaccine when you can) in 2003 I was prescribed acyclovir, by a doctor who knew both my financial situation (not great then) and compliance patterns.