Gilead Science’s remdesivir is on the very short list of drugs that have posted positive data in COVID-19, but now one U.S. lawmaker argues the company priced the medicine too high. Taxpayers spent nearly $100 million to save the drug from the "scrapheap," the lawmaker wrote, and are being repaid with "price gouging."
After federal researchers posted data showing Gilead’s antiviral cut advanced COVID-19 patients' recovery time by 31%, the FDA granted an emergency use authorization in May. The company unveiled its commercial strategy late last month, pricing remdesivir at $520 per vial, or $3,120 for a five-day course using six vials. For certain government programs, the price is $2,340 per course.
In response, Steven Pearson, president of cost watchdog group ICER, called the decision “responsible” and “a promising sign for pricing decisions of other treatments for COVID-19 on the horizon.”
Rep. Lloyd Doggett, chairman of the House Ways and Means Health Subcommittee, sees things differently. He wrote in a Wall Street Journal op-ed that the “fanfare … doesn’t acknowledge a $99 million federal investment that saved remdesivir from the scrapheap.”
“Taxpayers were the angel investors,” he added. “While Gilead quickly recoups its investment, taxpayers will see no return, only big bills.”
For its part, Gilead said in an SEC filing the company swiftly adapted to the pandemic by identifying remdesivir as a potential treatment, pausing some other drug trials and bolstering investment in the potential COVID treatment instead. The company believes it could spend $1 billion or more on the drug this year for a manufacturing scale-up, regulatory work and more.
Still, Doggett argues the company’s lower government price was “misleading” and was “a statutorily mandated one-third discount for four small federal programs.” Americans on Medicare, Medicaid, private insurance or those who are uninsured are not eligible for that lower price, he wrote. Doggett said President Donald Trump could have struck a “reasonable funding agreement" or ordered cheaper copycats to the drug to fight the “price gouging.”
A Gilead spokeswoman didn’t immediately respond to a request for comment on Doggett's op-ed. The company’s CEO, Daniel O’Day, has said Gilead believes “all patients will have access” at that price with government programs and company financial assistance.
Further, by enabling patients to leave hospitals sooner, the drug provides around $12,000 in savings per patient, O'Day argued. That doesn't factor in "direct benefits" to patients who recover sooner. O'Day argued the price is "well below" the drug's value, an argument echoed by Wall Street analysts.
But the congressman isn't alone in criticizing the drug's price. While Gilead received pricing praise from ICER’s Pearson, Public Citizen called remdesivir’s price tag “offensive” and said it could have been 10 times lower.
Since Gilead presented its initial time-to-recovery data, the company also unveiled a data analysis showing a lower risk of death for patients who received remdesivir. But the study wasn't a head-to-head prospective trial; it compared the Gilead antiviral's performance in a trial with a real-world cohort of severe COVID-19 patients on standard care.
Even before Gilead released its price, Doggett was among a group of lawmakers who wrote (PDF) to HHS secretary Alex Azar in late April requesting info about remdesivir’s development and taxpayer funding.