Remdesivir helps coronavirus patients — but at what cost?

Gilead is known for developing breakthrough drugs — including Sovaldi, a cure for hepatitis C, and Truvada, better known as PREP, the first treatment that can prevent HIV transmission. Both of those drugs, and related second-generation drugs Gilead developed, are broadly seen by scientists as genuine breakthroughs that save lives.

Remdesivir isn’t a knockout punch for Covid-19. But a clinical trial by the National Institute of Allergies and Infectious Disease, the agency headed by Anthony Fauci, showed it did lop several days off recovery time for seriously ill patients — getting them out of the hospital faster and perhaps reducing the number of deaths. Scientists are still studying the drug and the search for better therapies continues. In the meantime, the Food and Drug Administration swiftly granted an emergency use authorization for remdesivir so doctors can use it now.

Congressional Democrats are now raising questions about the drug’s cost — in part because Gilead received about $70 million in taxpayer dollars and assistance from the National Institutes of Health to run clinical trials. European officials are plotting contingency steps, fearing the Trump administration may take an “America First” approach and block everyone else from getting the medicine. A Bangladesh-based generic drugmaker is already planning its own version of the antiviral drug under an international program that lets very poor countries make copycats of expensive patented drugs.

Right now, Gilead is giving away about 1.5 million doses, and FEMA and HHS are in charge of distributing them. That’s probably enough for about 140,000 patients — but Wall Street analysts expect the supply to run out by late June, if not earlier. Gilead did not respond to a request for comment, but its CEO Daniel O’Day reiterated to shareholders Wednesday that the company “donated our existing supplies for global use.”

O’Day said that Gilead was just beginning to digest the results from the NIAID trial and would announce a price for remdesivir at a later date. “We’ll evaluate that data during the donation period and will consider the path of the pandemic and what role remdesivir can play,” he told shareholders.

The first coronavirus stimulus law, the CARES Act, says drugs must have “fair and reasonable” prices, although there’s no enforcement mechanism and stronger proposed language enabling HHS to help set a treatment’s price was dropped from the bill. Gilead spent $2.45 million lobbying the Senate in the first quarter of 2020, more than it ever had before, according to Open Secrets.

House Speaker Nancy Pelosi spokesperson Henry Connelly said that “fair and reasonable” language would likely apply to remdesivir because of the NIH involvement and because the federal government will likely have to purchase and distribute large quantities of it and other coronavirus medicines. Several Republicans in the Senate declined to comment or did not respond to a request for comment.

HHS didn’t respond to questions about its possible role in setting or negotiating remdesivir’s price. “HHS and FEMA are working together to finalize the process for equitable distribution of the limited doses of remdesivir donated by Gilead to reach patients in hotspots,” the department said in a statement. “We are encouraged to have so many private sector collaborators stepping up to assist in the whole-of-America pandemic response.”