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Honored Social Butterfly

Putting A Price On COVID-19 Treatment Remdesivir

I found this interesting and wondered what the opinion of the group here would be.  I would vote for a fair pricing based on what taxpayers have spent, what the drug company has spent and of course, what the final results are of saving healthcare dollars. 

 

Wonder why the USA government could not be listed as a patent participant and receive royalty payments from the drug.  That is what some Universities get for their time and efforts in research and development if it goes on to be developed by a drug company.

 

NPR UPSHOT 05/08/2020 - Coronavirus Crisis - Putting A Price On COVID-19 Treatment Remdesivir

 

Other countries DO use a efficacy measure when they determine the price of a medication.

Course since it is still experimental, it's efficacy is still somewhat questionable.

  • Will it be effective on everybody that gets to the point of needing it?
  • How many days of hospitalization or intensive care treatment will it prevent?
  • How many other costly treatment will it prevent?

From the link ~

Gilead Sciences, which makes remdesivir, is donating its initial supply of 1.5 million doses, but the company has signaled it will need to start charging for the drug to make production sustainable. It's unclear when that decision might be made.

 

"Going forward, we will develop an approach that is guided by the principles of affordability and access," Gilead CEO Daniel O'Day told shareholders during the company's annual meeting Wednesday.

 

. . . . Gilead said its investment in remdesivir this year "could be up to $1 billion or more," much of it for scaling up manufacturing capacity. 

 

"[G]iven that COVID-19 has been designated as a pandemic and represents an urgent public health crisis, we are likely to face significant public attention and scrutiny about any future business models and pricing decisions with respect to remdesivir," Gilead said in the quarterly filing.

 

How will the company balance its business calculations with the drug's potential value to society?

 

"On the one hand, Gilead will try to recover its R&D in an atmosphere in which it is able to potentially make a lot of money. On the other hand, the pressure will be intense not to charge what's viewed as too high a price."

 

Breaking with its usual practices, the Institute for Clinical and Economic Review, or ICER, an influential nonprofit that analyzes drug pricing, issued an expedited report on remdesivir.

  • "Under normal circumstances, we would be unlikely to do a report when the evidence is this raw and immature," ICER President Steven Pearson said in an interview with NPR. "But it was quite clear that the world is moving at a much quicker pace."
  • If the price is based just on the cost of making the drug, then a 10-day course of remdesivir should cost about $10, according to the ICER report. (Gilead said results of a recently completed study suggest a five-day course of treatment may be just as effective.)
  • But if the drug is priced based on the drug's effectiveness, ICER estimates it should cost around $4,500 — assuming the drug is proven to have some benefit on mortality. If it doesn't and the drug only shortens hospital stays, that value-based price goes down to $390.

Results from a federally funded study described by Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, suggested that remdesivir could reduce recovery time by a median of four days — 11 days to recovery for patients treated with remdesivir compared with 15 days for those who got a placebo. A potential survival benefit is less clear.

 

Rutgers' Carrier said he expects Gilead to set the remdesivir price somewhere between the $10 and $4,500 that ICER estimated. The company has already shown that it can respond to public pressure when it asked the FDA to rescind the orphan drug status it won for remdesivir, he pointed out.

 

Gilead "will be watched very carefully," he said, because of its prior history of pricing. He referred to two other Gilead drugs that drew scrutiny over high price tags. The company charged $1,000 per pill for Sovaldi, a cure for hepatitis C. And its HIV drug Truvada can cost $22,000 per year.

 

But there is such a thing as pricing remdesivir too low, said Craig Garthwaite, who directs the health care program at Northwestern University's Kellogg School of Management.

 

"We don't think this is the only drug we need," he said, adding that remdesivir doesn't appear to be a "home run" against the coronavirus, based on existing data. "The thing that would worry me the most is that we're somehow telling people that if you take the risky bet to try, and you'll go after a coronavirus cure and you do it, you're not going to get paid."

 

. . . . To date, the National Institutes of Health said it has obligated $23 million toward its COVID-19 remdesivir trial. And the U.S. Army Medical Research Institute of Infectious Diseases did some of the early in vitro and animal studies with the medicine prior to the pandemic.

 

Concerned about remdesivir's price, (a couple of Congress people) asked for a full breakdown of taxpayer funds that have gone toward the development of the medicine. "An unaffordable drug is completely ineffective," they wrote in the letter. "The substantial taxpayer investments in COVID-19 pharmaceutical research must be recognized."

 

So what is your opinion ?

 

If you want to read more about remdesivir and Gilead, here is another NPR article -

https://www.npr.org/sections/health-shots/2020/05/02/849149873/gilead-lobbying-rose-as-interest-in-c... 

 

Honored Social Butterfly

So what is your opinion ?

 

The best advice is to avoid the virus.

 

Even if Gilead gives the drug away the cost of being in a ICU will be ruinous, it does improve the patients chance getting off or avoiding a ventilator by 3 or 4 percent, and that could save tens of thousands of dollars.

 

The reality is however most people that get that sick won't be able to pay the bill. It doesn't really matter if they charge $ 10 or $ 4500.

 

I would be more concerned with the idea of the health system crashing in a year or two as bills go unpaid,  rates go up as insurance companies and hospitals raise prices to compensate, and even more people drop insurance policies because they can't afford it.

 

Tens of millions of families just lost their health insurance in a pandemic, they can't pay rent or mortgages,  they're having trouble buying food, they don't care about hospital bills, they're not going to pay them.

Honored Social Butterfly

Gruffstuff wrote:

 

"I would be more concerned with the idea of the health system crashing in a year or two as bills go unpaid,  rates go up as insurance companies and hospitals raise prices to compensate, and even more people drop insurance policies because they can't afford it.

****************************************************************************************

Yep, this pandemic could glaringly show the need America has for a universal health care system like all other developed nations have.


Man learns from history that man learns nothing from history.
Honored Social Butterfly

@gruffstuff 

Testing, testing, testing!

Again, running backwards into a situation...the cost of treatment versus prevention. Compare the cost of remedies and hospitalization, against the cost of a test to determine who has the virus, who is contagious, who is not infected, and then for the contagious to stay at home, then others can avoid being infected. 
But, that’s the general drift of our healthcare system...ignore preventative medicine, but put all the money towards drugs, treatments, and hospitalization...

running backwards into a situation!

Honored Social Butterfly

If tRump had came out pushing remdesivir, trump supporters would be posting articles supporting it.

 

It really is that simple.


Man learns from history that man learns nothing from history.
Honored Social Butterfly

Chasky said: 

If tRump had came out pushing remdesivir, trump supporters would be posting articles supporting it.

 

It really is that simple.

 

Sorry but you're wrong.  Remdesivir is used for Covid positive patients and IV treatment for really sick patients in the hospital who may die.  Hydroychloriquine, Z-Pack, and zinc are used for Covid positive patients both at home or in the hospital early diagnosis.  Both have mixed results. The latter may even cause death if given in late state Covid where the patient is about to go on a ventilator. 

 

 

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Honored Social Butterfly

NH

Remdesivir can be used on any one with the virus and works. You are correct it is an IV treatment. Hydro has shown not to work to treat the virus and Dr. have been told not to use it as it can do more harm than good. So both do not have mixed results. R works is used, H is not.

Honored Social Butterfly

John wrote:

 

Remdesivir can be used on any one with the virus and works. You are correct it is an IV treatment. Hydro has shown not to work to treat the virus and Dr. have been told not to use it as it can do more harm than good. So both do not have mixed results. R works is used, H is not.

 

 

Wrong again.

Both work or don't work! R is for serious cases in the hospital and H is for positive cases that are not serious either in the hospital or home!

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Honored Social Butterfly

Sorry but the medical Dr. say it does not work and should not be used. Now post other wise for the next 100 days and it will not change that fact. Neither you nor I can change the fact that Trumps drug does not work and should not be used for the virus period.  Now post away and change nothing.

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Honored Social Butterfly

There is a very simple answer to pricing. Have prices set for the drug co. You take cost of production and distribution and add about 10% plus over 20 years allow drug Co to get its development cost back. Govt. set prices and approves costs used in pricing. Now you say if it is done in another country. We take the drug and make it here and sell it for cost of production.

Honored Social Butterfly

@john258 

 

Here is another example - ORPHAN DRUGS

 

A company may work for years to develop an orphan drug; they spend tons of money, time, and resources on it to bring it to fruition - YEA, They find one but since there is only a few people in the US or the world that will find it beneficial what should it cost these people who's very life or quality of life could depend on it.

 

The cost of these are now born by the drug company, spread out with every other drug they may offer and profit from -

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Honored Social Butterfly

@john258 

So For-Instance, john258

 

There are (2) cancer drugs:

  • each targets the same type of cancer and stage with same patient protocols and current health status
  • they both have similar numbers based on your nuts and bolts pricing formula
  • one of them is proven to extend life for 7-months; the other is proven to extend life for 5-years

Does not the Quality Adjust Life Years (QALY) not count for anything?  Does not one of these drugs add more (life) value than the other?   According to your pricing formula, they would cost about the same.

 

I can give you lots more "for instances" and not just for medicine either - the same can be true of other treatments.

 

The effect of what they do, has value.  Efficacy has a measure and a value added.

 

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Honored Social Butterfly

Neither you nor I are experts in this area. My first goal is helping people. Your approach is making money. What I gave you was a way to help people and allow the co making the drug to make a profit. What you gave me was the way we are now which will get even worse as Trump moves to end health  care period.

Honored Social Butterfly

   :   is ignorance a treatable disease   https://www.statnews.com/2020/05/06/doctors-lambaste-federal-process-for-distributing-covid-19-drug-...

PRO-LIFE is Affordable Healthcare for ALL .
Honored Social Butterfly

@afisher 

 

Yea, I heard about this turmoil - and who is gonna get it and under what criteria.  This is because it is still an experimental drug and this is the batch that Gilead had already. 

 

I am more concerned about how well it will work, on whom and when it works the best - what the health and health cost savings it brings.  IF it works great, that does have value to all of us.

 

 

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Honored Social Butterfly

I heard that the drug costs $4,500 (as you said) and the number of times it's given is 5-10 times so the cost of the drug may be as high as $45,000 (given as an IV) exclusive of the hospital costs and it may not work! Gilead made some of this available to the government for free but limited quantities.

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