Jonathan M. Gitlin
Earlier on Wednesday, we reported on some clinical trial data that offered good, if ambiguous, news about treating COVID-19. In the study, participants treated with a drug called remdesivir recovered on average 30 percent quicker than those receiving a placebo. But who owns the drug, how much of it can be made, and what does it cost?
To answer the first question, remdesivir is owned by Gilead Sciences, a US biotechnology company. Gilead got its first patent for the drug in 2017 when the company was originally targeting it as a possible treatment for the Ebola virus. That didn’t pan out, but as our earlier article explains, biochemical similarities in how the Ebola and SARS-CoV-2 viruses function led Gilead to see if remdesivir could be repurposed for treating COVID-19. Gilead’s patents mean that it has a monopoly on the drug in the United States, so barring government intervention or Gilead licensing the patent to others, it’s the only company that can manufacture it until 2037, at which point a generic version could be possible.
To answer the second question, Gilead announced in April that it had ramped up production of remdesivir at its factory in La Verne, California, in January, and by the beginning of April, it had already stockpiled enough to treat 140,000 patients, each over the course of 10 days. The company also said that it plans to produce enough remdesivir to treat 500,000 patients by October and a million patients by the end of 2020. (This explains why there was some outcry in March when it was revealed that Gilead had applied for something called “orphan drug status” for remdesivir, which is supposed to be reserved for rare diseases. Gilead withdrew that application.)
Finally, there’s the question of how much that will cost. As of today, we don’t know how much Gilead intends to charge for remdesivir in the US or elsewhere. In CEO Daniel O’Day’s April letter that revealed the existing stockpile, he wrote that the company “is providing the entirety of this existing supply at no cost, to treat patients with the most severe symptoms of COVID-19. The 1.5 million individual doses are available for compassionate use, expanded access, and clinical trials and will be donated for broader distribution following any potential future regulatory authorizations.”
A recent study published in the Journal of Virus Eradication attempts to analyze the cost of manufacturing remdesivir. The authors looked at the chemical synthesis of the drug and concluded that a 10-day course for one person would cost $9, allowing for 20 percent losses during formulation, plus the cost of the vials, a profit margin, and tax. However, whether it costs Gilead that to actually produce the drug is unknown, and one needn’t be a scholar of the US healthcare system to be skeptical that a novel treatment would end up being quite so cheap.