Since the COVID-19 pandemic began, doctors, researchers, and drug-makers have been searching for an effective treatment for the virus that has now, as of July 7th, killed more than half a million people worldwide .
Remdesivir by Gilead Sciences was the first drug to show benefit against the novel coronavirus, and as such it’s arrival on the market has been highly anticipated. Many were disappointed, however, when the company announced at the end of June that receiving treatment with the drug would cost thousands of dollars.
Gilead Sciences Charging Thousands
After receiving emergency use authorization in May, the drug company Gilead Sciences has been donating doses of its coronavirus drug, Remdesivir, to the US government for distribution. On Monday, June 29, the company finally released the pricing for the drug, and many were left with sticker shock.
As of July first, the company will now be charging 390 dollars per vial to governments “of developed countries”, and 520 dollars per vial to US private insurance companies. This means that for the majority of patients who will receive a five-day treatment plan, the cost to the government will be 2340 dollars, and the or 3120 dollars for patients with commercial insurance .
The longer, ten-day treatment plan that uses eleven vials of Remdesivir will cost the government 4290 dollars per patient, and 5720 dollars for a US patient with private insurance .
During a conference call with reporters on the day of the announcement, a senior official in the Department of Health and Human Services said that individuals who are not insured will be covered under provisions from the CARES Act, and out-of-pocket costs for individuals with private health insurance will depend on the individual insurance plan .
“Whether you’re covered by a private insurer, whether you’re covered by a government insurer, whether you’re uninsured with Covid-19, there will not be an issue for access with remdesivir,” said Gilead CEO Daniel O’Day .
The Price is Drawing Criticism
O’Day told reporters that given the circumstances, the company believed they had to deviate significantly from the normal circumstances and price the drug to ensure access rather than exclusively on value to patients.
The price, however, was very quickly criticized, with one consumer group calling it an “outrage” because of the amount of taxpayer dollars that were used toward its development.
“This is a drug that received at least $70 million in public funding,” said Peter Maybarduk, a lawyer at the consumer group Public Citizen. “Remdesivir should be in the public domain.” 
Other experts are pointing out that this is a very high price for a drug that has not demonstrated any ability to actually save lives. Remdesivir, which interferes with the virus’s ability to copy its genetic material, was shown to decrease recovery time in patients by 31 percent in a US government-led study. Patients who received the drug recovered in eleven days on average, compared with 15 days for those who did not.
The drug, however, did not improve survival rate in preliminary studies.
Dr. Steven Nissen of the Cleveland Clinic said that this is a high price for a drug that has not been shown to decrease the mortality rate.
“Given the serious nature of the pandemic, I would prefer that the government take over production and distribute the drug for free. It was developed using significant taxpayer funding.” 
Dr. Peter Bach, a health policy expert at Memorial Sloan Kettering Cancer Center in New York, agrees, stating that the price demonstrates that drug companies can’t be trusted to do the right thing because of a pandemic.
“The price might have been fine if the company had demonstrated that the treatment saved lives,” he said. “It didn’t.” 
In a press release from Gilead Sciences, O’Day defended the price, saying that a quicker recovery time saves hospitals approximately twelve thousand dollars per patient. The cost savings for the healthcare system makes Remdesvir a highly valuable drug treatment, and this is without considering the benefit to the patients themselves, who recover faster with the drug .
Dr. David Boulware, an infectious disease specialist at the University of Minnesota, believes that the shortened recovery time could justify the price, despite the fact that it doesn’t actually save any lives.
“From the health system perspective, if remdesivir can shorten duration of hospitalization by four days, then the medicine provides a reasonable value,” he said .
While remdesivir is the first drug to demonstrate efficacy against the novel coronavirus, it is not the only one that shows promise.
Earlier in June, researchers at Oxford University released results from their clinical trials which found that the cheap and widely available steroid, dexamethasone, can decrease the risk of death for COVID-19 patients by one third, and by one fifth for patients on supplemental oxygen .
If other therapeutics like dexamethasone are made widely available to the public, they could render remdesivir obsolete.
Gilead Stands to Make a Significant Profit
According to the company, Gilead Sciences will have spent one billion dollars on developing and making remdesivir by the end of 2020. While they only expect to claw half of that back this year, analysts anticipate that 2021 profits will exceed two billion dollars .
The company is also continuing research and development to figure out how remdesivir can be used to more effectively treat COVID-19, and is planning on beginning human trials for an inhaled version of the drug .
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