Remdesivir – Worth the Money
In May 2020, the U.S. Food and Drug Administration (“FDA”) issued an emergency use authorization for Gilead’s drug remdesivir to combat COVID-19.[1] Remdesivir is an intravenous antiviral medication now intended to be used on hospitalized patients with a severe form of the disease.[2] The authorization is temporary and does not guarantee the safety or efficacy of remdesivir.[3] Given the extremely limited scope of authorization, the federal government is handling the distribution of the drug.[4] According to preliminary results, remdesivir decreases recovery time for coronavirus patients from fifteen days to eleven.[5]
All seems great and hopeful—that is, if the price drops. Remdesivir is available at $520 per bottle, or $3,120 for the entire course of treatment, to those with private insurance, while it is priced at $390 per bottle, or $2,340 for the whole treatment, for those with government-sponsored insurance such as Medicare.[6] With only “modest” results that do not seem to decrease the mortality rate, the pricing remains controversial.[7]
Experts suggest that the current pricing of remdesivir is rational, since other drugs being tested will be more expensive once put on the market.[8] In fact, Gilead charged less than the $5,000 per treatment regimen that was expected by Wall Street analysts.[9] Decreasing hospitalization by four days actually saves $12,000 per patient.[10] Decreased hospitalization means more capacity to accept new patients, and more oxygen available to them.[11] With that in mind, maybe remdesivir is priced reasonably?
Opponents argue that this “monopoly” over the pricing of such a vital drug must be broken to overcome the shortages that hospitals are experiencing.[12] Some point out that taxpayers have every right to remdesivir, since its research was funded by taxpayers through the National Institute of Allergy and Infectious Diseases.[13]
The Institute for Clinical and Economic Review (“ICER”) puts a fair price range of the drug at somewhere between $2,520 and $5,080 per treatment.[14] However, ICER also points out that if remdesivir does not increase survival rates, it might be worth as little as $310.[15] As remdesivir so far has not been shown to do so, the current price may be too high for its value.[16]
But why should remdesivir’s “value” determine its price in the first place? After all, other valuable medical procedures, such as organ transplants, are not priced based on their “value.”[17] Dexamethasone, a generic steroid that also has shown promising results in COVID-19 patients, costs less than $1 per day.[18] Why should it not cost as much as remdesivir, if to be priced on its “value” alone?[19] Remdesivir’s price does not incentivize other companies either—a price tag of $390 per treatment course alone would provide enough profits to be an incentive to others.[20]
This is not the first time Gilead has been scrutinized for outrageous prices on essential medications: Gilead is notorious for charging thousands of dollars for Truvada, a combination pill that can protect people against contracting the human immunodeficiency virus, better known as H.I.V.[21] “Impoverished” populations are more vulnerable to the virus, raising questions about whether high prices are ethical on drugs that are especially necessary to these economically unstable patients.[22]
So the question remains: is remdesivir actually worth the money, when it hasn’t been formally approved by the FDA, does not decrease mortality, and a cheaper alternative is available?
Footnotes
