In the United States, Gilead Sciences set the price for remdesivir, its antiviral drug that can shorten hospitalization stays for individuals ill with coronavirus disease 2019 (COVID-19), based on insurance factors, and is allowing generic drug makers to create the drug for less in low to middle income countries.
Gilead Sciences Monday set the price for remdesivir, its antiviral drug that can shorten hospitalization stays for individuals ill with coronavirus disease 2019 (COVID-19) from SARS-CoV-2 infection, at $520 a vial, or $3120 per patient for a typical treatment course, for those with private insurance.
The price those not covered by private insurance will be $390 per vial. A treatment course is 6 vials. The FDA approved the drug for emergency use in some patients and the company has applied for full approval.
The Institute for Clinical and Economic Review (ICER) last week said remdesivir would be cost-effective at a price range of $4580 to $5080 if it saved lives. However, news that an inexpensive steroid, dexamethasone, which does not have a patent, improves survival means remdesivir should be priced between $2520 and $2800, ICER said.
In a statement posted to the company’s website, Gilead’s CEO, Daniel O’Day, said, “There is no playbook for how to price a new medicine in a pandemic. We are aware of the significant responsibility that comes with pricing remdesivir, and the need to be transparent on our decision.”
In “normal” times, he said, the drug would be priced according to the savings it provides. He said that by shortening hospitalization time by an average of 4 days would result in a savings of $12,000 per patient. He also said that the company expects its investment to exceed $1 billion.
Analysts at Royal Bank of Canada told Reuters they saw revenue potential of $2.3 billion from the drug in 2020, helping to offset those development and distribution costs.
But a consumer group, Patients for Affordable Drugs (PAD), criticized the price, saying that taxpayers, through the National Institute of Allergy and Infectious Diseases, funded the COVID-19 remdesivir trial and that the institute expects to spend a minimum of $30 million on remdesivir studies by the end of 2020. It also cited earlier government spending when the drug was studied for Ebola.
Dexamethasone costs less than $1 per day, PAD said.
By contrast, ​​i​​​n 127 poor or middle-income countries, Gilead is allowing generic makers to supply the drug; 2 countries are doing that for around $600 per treatment course.
Another group, the Pacific Business Group on Health, which represents employers' concerns, also said in a statement sent to The American Journal of Managed Care® (AJMC®) that it has "serious concerns" with the price, citing the ICER analysis and taxpayer-backed research support.
"It is another unfortunate example of drug manufacturers taking advantage of their monopolies to set prices at whatever level they want. It’s also a worrisome indicator that they will exploit the COVID pandemic to maximize their profits at the expense of patients. The bottom line is that this adds to the financial burden on employers and their employees and families, many of whom are already struggling from the impact of the COVID pandemic," the group said.
HHS is managing the allocation of remdesivir to hospitals until the end of September through an agreement with Gilead. The agency said Monday it has more than 500,000 treatment courses. This represents 100% of Gilead’s projected production for July of 94,200 treatment courses, 90% of production in August and September, in addition to an allocation for clinical trials, HHS said.
The agency said the drugs will be shipped by AmerisourceBergen, at the $3200 price, or what HHS said was the wholesale acquisition cost.
“President Trump has struck an amazing deal to ensure Americans have access to the first authorized therapeutic for COVID-19,” said HHS Secretary Alex Azar in a statement. “To the extent possible, we want to ensure that any American patient who needs remdesivir can get it.”
After September, HHS will stop managing the allocation, Gilead said.
The treatment courses that the company has donated to the United States and other countries will run out in about a week; the prices will apply to the drug after that, O’Day told the Associated Press.
In one study, remdesivir shortened recovery time by 31%—11 days compared with 15 days. While it has not improved survival according to preliminary results after 2 weeks of followup, results after 4 weeks are expected soon.