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Remdesivir 101: What Is This Drug, Are There Alternatives And How Much Might It Cost?

ARI SHAPIRO, HOST:

There are a handful of experimental products being studied as potential COVID-19 treatments. The drug remdesivir is farthest along right now. For more on what it does and who's likely to get it, we are joined by NPR pharmaceuticals correspondent Sydney Lupkin.

Hi there.

SYDNEY LUPKIN, BYLINE: Hi, Ari.

SHAPIRO: Remind us first why this drug is in the limelight.

LUPKIN: Sure. Remdesivir is an intravenous drug made by Gilead Sciences. It's an antiviral that interferes with the coronavirus' ability to make copies of itself. The Food and Drug Administration has authorized remdesivir for emergency use during the pandemic for severely ill COVID-19 patients who are in hospitals, but it's not the same as a full approval after rigorous FDA review. Remdesivir was approved in Japan this month and is expected to get approval in Europe soon, maybe even this week.

SHAPIRO: Now, this is just one of many drugs that scientists are studying as possible COVID-19 treatments. So does that mean there is still room for something better than remdesivir to come along?

LUPKIN: Yes, for sure. Experts stress that remdesivir isn't a cure. The drug appears to shorten hospital stays by about four days. That's according to Dr. Anthony Fauci, who directs the National Institute for Allergy and Infectious Diseases. However, it's not clear whether remdesivir has an effect on survival.

SHAPIRO: Still, shortening a hospital stay seems helpful given the shortage of hospital beds available. Is there enough of this drug to go around?

LUPKIN: There's a limited supply, and the federal government is in charge of distributing it. Gilead has said it will donate its initial supply of 1.5 million doses. Six hundred thousand vials of that would be earmarked for the U.S. and would be used for hospitalized COVID-19 patients who aren't in clinical trials. Today I got a copy of a letter that went out from the Department of Health and Human Services to state governors, and it said that Gilead was donating an additional 300,000 doses. But Gilead declined to confirm that. The company tells me that it's in talks with the U.S. government about the amount of remdesivir needed through the end of June. Gilead expects to be able to increase its supply of remdesivir in July as it's manufacturing stuff (ph).

SHAPIRO: So if this supply is limited, is the amount that is available going to the right places? How is it being distributed?

LUPKIN: The initial rollout of these doses was met with confusion. Some hospitals and states didn't know why they were left out or when they might get some of the drug. At first, the administration shipped cases of remdesivir directly to hospitals in a handful of states, but they weren't always the hospitals that had the most COVID-19 patients. Here's Rep. Lloyd Doggett, a Democrat from Texas who has asked for an explanation.

(SOUNDBITE OF ARCHIVED RECORDING)

LLOYD DOGGETT: The states - not clear why and how much they get, nor is it clear what methods they are using to allocate.

LUPKIN: He says a few hospitals in his district have received cases of remdesivir, but they don't know whether more will arrive. He's one of the members of Congress who have called for more transparency into the distribution of remdesivir.

SHAPIRO: And once this donated supply is used up, has Gilead said how much it plans to charge for the drug?

LUPKIN: Nope. Gilead hasn't said how much it plans to charge for remdesivir yet at all. There are estimates that range from a few hundred to thousands of dollars. And there is debate around whether the price should be kept very low to keep the drug accessible or much higher as an incentive for companies to really work hard on treatments and vaccines. Of course, taxpayers helped fund some of the remdesivir research, so some members of Congress want to make sure Americans get a fair price.

SHAPIRO: That's NPR's Sydney Lupkin. Thanks a lot.

LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.

Sydney Lupkin is the pharmaceuticals correspondent for NPR.