The US pharmaceutical giant Gilead has donated a supply of the antiviral medication remdesivir to Australia’s national medical stockpile, with the federal health minister, Greg Hunt, saying there will be enough of the drug to meet Covid-19 patient demand.
It followed news overnight that the US government bought virtually all of the global supply of remdesivir for the next three months. The drug has shown some promise in helping Covid-19 patients recover faster. However, it is not a cure. Remdesivir is the first drug approved by licensing authorities in the US to treat Covid-19, prompting the White House under US president Donald Trump to buy more than 500,000 doses, representing all of Gilead’s production for July and 90% of August and September.
However, a spokesman for Hunt said this would not affect the ability of doctors to administer the drug in Australia. Australia’s Covid-19 Clinical Evidence Taskforce currently states that the use of remdesivir for adults with moderate, severe or critical Covid-19 may be considered by doctors. This recommendation will be updated as further evidence from clinical trials becomes available.
“The Australian government has received from Gilead a donated supply of remdesivir to the national medical stockpile, which will be available for use in eligible patients prescribed by a medical practitioner,” the spokesman said. “Australia currently has sufficient supply of remdesivir to meet current patient needs on the basis of our expert medical advice.”
Associate Professor Alice Motion from University of Sydney’s school of chemistry said the actions by the US were nonetheless “a real concern”. Motion, who works as part of open source drug discovery projects including the Breaking Good citizen science project, said: “We would want to make sure something like this isn’t possible for a vaccine.
“A vaccine should be available to people all over the world rather than one country, or a group of countries having preferred access to a medicine.
“Remdesivir is a medicine that helps people to recover faster, but imagine if the same thing happened with a vaccine that emerges. That would be terrible.”
She said the actions of the US raised fundamental issues about fair and equitable access to medicine.
“The other issue is whether everyone in the US will now have equal access to remdesivir too,” Motion said. “Equal access is not just an issue on a global level, but within countries.”
If remdesivir does prove to be significantly effective in treating Covid-19, the drug would be needed not only in the US but globally, Associate Professor Barbara Mintzes from the University of Sydney’s Charles Perkins Centre and School of Pharmacy said.
“The US arrangement to buy 500,000 doses of remdesivir from Gilead raises concerns not only about access in other countries but also how to prevent profiteering from the Covid-19 pandemic and ensuring that patients who need treatment are able to access it,” she said. “Gilead announced its global price for remdesivir on June 29 as US$390 per vial. The Guardian reports that the cost will be US$3,200 for a six-day treatment, or A$4,607. The cost of production of remdesivir has been estimated to be less than US$1 per day or US$6 (A$8.64) for a six-day course of treatment.
“Gilead has licensing agreements with manufacturers in Egypt, India and Pakistan to supply remdesivir to 127 low to middle-income countries. The US deal with Gilead and limits on which countries can be supplied under this licensing agreement leave countries like Australia in the lurch: unable to access remdesivir from Gilead at a high price – as the US is doing – and unable to access it at a low price from generic manufacturers, as lower income countries can.”
As for a solution, Mintzes said in a public health emergency governments can issue compulsory licenses to bypass patent protection and either produce a drug themselves or buy the drug from generic manufacturers. The Netherlands is currently considering an amendment to its patent law to allow compulsory licensing of remdesivir.
“Currently we don’t know for sure whether remdesivir will prove to be an important treatment for Covid-19,” she said. “If it does, given that the US is buying out Gilead’s supply, and also given the extremely high price as compared with costs of production, the obvious solution for Australia would be to also consider compulsory licensing.”