Remdesivir is now authorized in Canada to treat severe COVID-19 cases. But accessibility issues and early clinical trials suggest it is not going to rapidly be a cure for all.
September 25, 2020
As COVID-19 cases keep rising in Canada and elsewhere, cautious hope surrounds new experimental antiviral drug remdevisir. It was added to Canada’s toolbox against COVID-19 in late July and is currently available for use to treat patients with severe COVID-19 symptoms, as part of ongoing trials to better determine the drug’s efficacy. But early clinical trials and pricing issues suggest that it will be a long time before it ever becomes more widely available.
Free market and health care in pandemic times
“It's not clear to me how much supply we will get for the next number of months,” worries Lisa Barrett, an infectious diseases clinician-scientist at Dalhousie University. “One of the challenges [with remdesivir] is: it definitely doesn't work if you can't give it to someone and if there's not enough supply, then that's a problem.”
Minister of Public Services and Procurement Anita Anand recently announced that the Canadian government has signed new agreements with Gilead Sciences and McKesson Canada to secure a supply of up to 150,000 vials of remdesivir. The doses should begin arriving at Canadian hospitals this month.
But accessibility to the drug could still become an issue going forward “both because of its availability and also because of its cost,” says Srinivas Murthy, a clinical associate professor at the University of British Columbia and principal investigator of the Canadian Treatments for COVID-19 (CATCO) trial.
Back in June, Gilead Sciences decided to charge $2,340 per patient per course for developed countries, a price that could rise to as much as $3,120 per patient. The cost to produce one vial of remdesivir, according to the Institute for Clinical and Economic Review, is less than $1.
This recently prompted a bipartisan group of 11 U.S. lawmakers to ask Gilead to “commit to being a part of [the U.S.]’s recovery from COVID-19, both medically and economically, by repricing this drug more affordably” because the current pricing suggests that Gilead “prioritizes unreasonable profits over recovery and sets a dangerous precedent for future treatments in development.”
Promising early results
Health Canada’s approval of the drug follows the results of a study sponsored by the U.S.’s National Institutes of Health, in which remdesivir seemed to “help people with severe symptoms get better some days faster, maybe three or four days faster,” explains Dr. Barrett.
However, “we haven't seen enough data to say that it improves whether you die or not, if you have COVID-19 and get remdesivir,” points out Dr. Murthy. “And so we're still waiting for more clinical trials to be done to confirm that or not.”
The reason why remdesivir is interesting is that, so far, most other medications used in treating COVID-19 patients have been targeting the inflammation in the lungs; but remdesivir “works on the virus itself and reduces the virus's ability to reproduce itself. With that, it can reduce the ability of the virus to cause damage, we think,” explains Dr. Murthy.
Though Dr. Michael Curry, another clinical associate professor at UBC, warns: “Is remdesivir a cure for COVID-19? No. It is not a cure, nor is it a “game-changing” treatment, but it’s a new tool in our armamentarium to combat this pandemic.” Further trials are now being conducted for wider use, such as to treat patients with milder symptoms, though benefits will probably not be as clear from trials with this particular group since “patients with mild illness get better anyway,” points out Dr. Curry.
From a safety perspective, “the data is suggestive that it's a reasonably safe medicine” continues Dr. Murthy. But it is administered in an intrusive way, intravenously, “and so that restricts its ability to be used in different settings,” says Dr. Barrett. “Until it becomes different in terms of its delivery mode, we won't be able to use it for preventing infection.”
This story was commissioned by Yahoo News Canada.