As the coronavirus pandemic in the U.S. spins out of control, with some 3 million confirmed cases and more than 130,000 deaths, the absence of federal coordination and lax guidelines in many states, have produced the largest numbers of infections and fatalities anywhere in the world.
While people across the globe world await the development of an effective vaccine that has the potential to end the health crisis, the next best thing is identifying therapeutic drugs that can effectively treat patients suffering with the COVID-19 virus. Studies have shown that remdesivir, a drug produced by Gilead Sciences, helps reduce the recovery period in patients with the coronavirus. One of the first to show effectiveness against COVID-19, remdesivir was given emergency use authorization by many countries, including the U.S., and is presently being administered to patients.
On June 29, Gilead announced that patients receiving remdesivir for a typical course of treatment, would be charged $3,120 for individuals with private health insurance, and $2,340 for those covered by government programs like Medicaid. Public Citizen notes that the drug was developed with at least $70.5 million in public funding, and is being priced 10 times higher than the cost-effective benchmark price of $310. Between The Lines’ Scott Harris spoke with Peter Maybarduk, director of Public Citizen’s Global Access to Medicines Program. Here, he explains why pharmaceutical companies like Gilead should be prohibited from price gouging the public on essential drugs, especially during a global health crisis.
PETER MAYBARDUK: Gilead, like most corporations, prices according to its ability to maximize profits and please shareholders. In the pharmaceutical industry, companies are pricing according to monopoly benefits. In other words, if you control a patent or marketing exclusivity on a drug, you can prevent competitors from entering that market. You can’t just necessarily substitute one medicine for another. We need to do what’s best for each patient.
So there is sort of a monopoly over a market as defined by what patients would most benefit from for a particular disease. And companies fully exploit that and charge extremely high prices. So that’s the circumstance that we are in with Gilead right now. However, the public actually has rights in this drug. The public owns core patents on remdesivir because U.S. government funding and science drove the development of drugs from the beginning. U.S. government scientists, including the National Institutes of Health and in the military were involved in isolating the compound and involved in testing it initially against ebola before it was later repurposed for coronavirus. And taxpayers now have been running major clinical trials at NIH, Dr. Tony Fauci and others have been telling people about in their pressers.
Each of those things are expensive. You’ve got a combination of federal scientists actually leading the research teams in some cases. And another cases, major federal grants going to Gilead to push a next stage forward. So essentially, Gilead scientists and all of us have been partners in the development of this drug from the beginning, but now we’re ceding our rights and we are just telling Gilead, “Do what you want with this drug. Charge what you think is appropriate and we’ll pay it.”
It doesn’t have to be that way. We could actually put remdesivir in the public domain. We could license generic competition for it. We could use the U.S. government’s leverage from being a partner in the development of the drug to insist on affordable pricing and adequate supply for the world. And we haven’t done those things.
SCOTT HARRIS: So Peter, the Trump administration doesn’t seem to have had any inclination to act to limit the pricing here. But does Congress have any power to limit this drug company’s pricing of remdesivir?
PETER MAYBARDUK: Yeah, I suppose Congress could pass particular resolution related to it. But what we really look for are systemic solutions where for example, Congress introduces reasonable pricing authority and two recent efforts in that are the TRACK (Taxpayer Research and Coronavirus Knowledge) Act and the MMAPP (Make Medications Affordable by Preventing Pandemic Pricegouging) Act, introduced by Reps. (Lloydd) Doggett and Jan Schakowsky among others that would both sort of track government investments and require transparency and accountability and impose some reasonable pricing constraints and licensing constraints and potentially strip the exclusivity from these products so that they’re not monopolized when they first come to the market. We have competition when they first come on the market. So there are legislative solutions being pursued by forward-thinking members of Congress. However, we don’t expect them to pass immediately.
And it is just worth noting that the U.S. government actually already has authority under existing law to act. Now, you know, the Trump administration has bungled this like so many other things. Its initial remdesivir rollout, the Trump administration got many donation doses from Gilead, and it was impossible for anyone to tell where they were going or why they were appearing at some hospitals and not their neighboring hospitals with no explanation. And even the hospitals themselves couldn’t explain. It seems to be a part of the sort of Jared Kushner clique of “bros” that were screwing this thing up. So the Trump administration hasn’t done its job in this area at all, but it could, and again, it’s sort of important to think about the next technology and potentially a next government, a next U.S. government that could do things very differently if all of us sort of lift up the how and why and our expectations for forthcoming COVID-related medical technologies.
SCOTT HARRIS: At Public Citizen, you have an effort underway to force Big Pharma companies to halt all price increases during the coronavirus pandemic when so much is at stake for so many. Tell us briefly about that campaign.
Not increasing the prices of existing medicines is the bare minimum that any of us could possibly ask of the pharmaceutical industry during a pandemic. Nevertheless, the industry is increasing prices on older, existing medicines, hundreds of them, as it does during normal times. A part of the business model is you introduce it high prices in the first place, but then prices don’t fall over time in the pharmaceutical industry. They go up, often twice a year. So we’ve made the basic call that at minimum, companies should freeze their price increases across their portfolios for the duration of the pandemic. And we’d call on the leading companies to do this. We’ve gotten a few noncommittal replies back and a fair bit of silence as well, but we’re not the only ones asking for it. Coalitions of payers and patients and others are making the same ask. So no price increases lifted up at the starting point. And hopefully from there, we can start getting some federal regulation.
For more information, visit Public Citizen at citizen.org.
