Remdesivir can cut down the average recovery time of patients by four days, according to the results of a government-backed clinical trial published in the New England Journal of Medicine in May. But the study did not indicate the drug would lead to fewer deaths.
National Institute of Allergy and Infectious Diseases Director Anthony Fauci said at the time the results were a good "proof of concept" and could lead to other advances.
Another drug, dexamethasone, an inexpensive steroid, showed stronger evidence of a benefit. It reduced mortality in severely ill patients in a large University of Oxford clinical trial.
The company will charge U.S. patients a higher amount for remdesivir than in other rich countries. The price in the U.S. is higher "because of the way the U.S. system is set up and the discounts that government healthcare programs expect," according to a Monday letter by Gilead Sciences CEO Daniel O'Day.
Gilead said it priced the drug "below value" based on its estimation that hospitals could save $12,000 per patient that is discharged earlier than anticipated without the drug.
"As the world continues to reel from the human, social and economic impact of this pandemic, we believe that pricing remdesivir well below value is the right and responsible thing to do," O'Day wrote.
Patient advocates describe Gilead's social responsibility differently. They contend that, given the historic human toll of the pandemic, the drug should be priced at $1, slightly above the estimated cost to produce it.
The advocacy groups Public Citizen and Knowledge Ecology International estimate the taxpayer contribution to the development of remdesivir at a minimum of $70.5 million. Patient advocates with PrEP4All argue that the government should own patents on the drug.
"In an offensive display of hubris and disregard for the public, Gilead has priced at several thousand dollars a drug that should be in the public domain," said Peter Maybarduk, director of Public Citizen's Access to Medicines Program, in a statement.
A report by the Institute for Clinical and Economic Review indicated a $310 price for remdesivir alone would be cost effective, unless the drug is proven to reduce mortality.
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