Many of you will remember that I was pleased when remdesivir showed efficacy as the first effective antiviral drug for COVID-19. Today, its owner Gilead Sciences announced that most American consumers will be charged $3,120 for a typical course of treatment. The only exception to this pricing will be for US government agencies, such as Veterans hospitals. Pricing for other countries is reportedly still being negotiated, and if usual standards hold will be lower than the price in the United States.
The cost of remdesivir is not in the realm of the most expensive drugs, such as $100,000 cancer drugs or multimillion-dollar gene therapy, but is significant. It is actually more expensive than many other antibiotics or antiviral drugs. This raises the question of its value as part of the health care treatment for COVID-19.
While definitive clinical data on remdesivir is still not entirely available, people have raised concerns that the drug did not show a significant reduction in deaths from infection COVID-19. The one thing that is significant, however, is that the hospital stays of patients treated with remdesivir were 1/3 shorter than for patients without treatment. This is approximately an 8 day hospitalization on drug as compared to 12 days without. Gilead estimates it will reduce hospital costs by $12,000 per patient, on average.
Even the Institute for Clinical and Economic Review (ICER), a nonprofit group that criticizes pharmaceutical prices, said last week that remdesivir would be cost-effective at a range of $4,580 to $5,080 a patient. They did add that if dexamethasone treatment in COVID-19 infections has a real, beneficial effect (which we have no way of knowing right now), then remdesivir’s projected value drops to $2,520 to $2,800 a patient; less than its projected cost.
The price is disconcertingly high to some. In India and Bangladesh, where Gilead licenses out production, the estimated cost of the generic version will be less than $1,000. On the other hand, several pharmaceutical analysts thought the price was too low and Gilead had succumbed to governmental pressure. STAT news called the price “middle of the road.”
In summary, Gilead has priced remdesivir at the middle of the antiviral spectrum, but not so high that price will be an obstruction to its use.
I also direct you to a great diagram in the WSJ that shows how the drug works!