Is the New Coronavirus Drug a Cure?
Since the outbreak of the new coronavirus, the lack of specific drugs has been a serious headache for the medical community battling the spread. Furthermore, the lack of a reliable treatment has fed into the fears of the public.
Demand for access to not yet approved medications that might cure the virus has been overwhelming and the drug manufacturer Gilead has come into the national spotlight. The Gilead drug remdesivir was able to make the first clinical case get better in one day. "In recent weeks, there has been an exponential increase in compassionate use requests for emergency access to remdesivir" according to Gilead.
And now, remdesivir has been called “the miracle for coronavirus”. In a public statement, Gilead said "enrollment in clinical trials is the primary way to access remdesivir to generate critical data that inform the appropriate use of this investigational medicine."
Remdesivir resembles the RNA base adenosine, shown here as a monophosphate:
Remdesivir was originally developed to combat the Ebola virus disease and Marburg virus infections. Remdesivir was developed very quickly by Gilead back in 2013-2016 to assist with the Ebola outbreak in Africa. The US Army assisted in the testing and helped fast track approval of remdesivir for its usage in hard hit Africa.
Furthermore, the drug has been found to show antiviral abilities against any single stranded RNA virus. Gilead is now testing the drug specifically on Coronavirus in two different patient enrolled tests and initial evidence has been promising. However the nation of Congo did announce that the drug was less effective in fighting Ebola than other approved methods. So will remdesivir have greater efficacy against the Coronavirus?
Dr. Richard Novak, chief of infectious disease at the University of Illinois at Chicago is administering a test of the remdesivir and said “We don’t know if it works. It could be a total failure, but if you don’t do this type of testing, you won’t know the answer. I think it will have some effect. Will it be a miracle drug? Probably not, but who knows.”
Dr. Novak warns of the disease itself, “This disease is really insidious. A week into it you can just sort of crash. People don’t realize they are getting out of breath ... and then their lungs fill up with fluid.” And Dr. Novak does not believe we have hit the peak of the virus yet, “We’re still on the upswing. It’s gonna get much worse,”
Vanderbilt University’s Mark Denison and the University of North Carolina at Chapel Hill’s Ralph Baric were able to prove in 2017 the remdesivir "could inhibit replication of the coronaviruses that cause both severe acute respiratory syndrome (SARS) and MERS in human lung cells."
So, can this not yet approved Coronavirus medication bring Gilead back to investor favor? The calm response from the stock market seems to have given us the answer.
After acquiring Triangle, an AIDS pharmaceutical company, and Pharmasset, a hepatitis C pharmaceutical company, Gilead achieved a dominant position in HIV, hepatitis C, and hepatitis B therapeutics. Relying on Sovaldi and Harvoni, two miracles for hepatitis C, Gilead even improved the cure rate to more than 90%.
As a result of this, Gilead was sought by investors in the stock market. In 2015, Gilead's stock price reached a maximum of $123.37. But after that, affected by price cuts and the shrinking hepatitis C market, investors started to worry about Gilead's growth and its stock price began to fall endlessly, even to the level before the introduction of Sovaldi. In 2019, its stock price only increased by 3.9%, far less than the 24% increase in the Nasdaq Biotech Index.
Even if in time remdesivir is listed as a COVID-19 specific drug, the revenue brought to Gilead may not be enough to change investor sentiment. The World Health Organization has reported 530 thousand coronavirus cases worldwide. Using the pricing of Sovaldi, which costs $84,000 for a course of treatment, as a guide and if 1/5 of patients receive remdesivir treatment, remdesivir could bring Gilead $8.9 billion in revenue. (The total revenue of Gilead in 2019 was $22.4 billion.)
Continuing to use Sovaldi sales as an example, it sells for about $1,000 a pill in the U.S, while a generic version costs only $4 a pill in India while China pays $8,900 for a course of treatment. If this pricing prevails for remdesivir, it is foreseeable that income from remdesivir would have a limited effect on driving Gilead's overall income and stock price.
But the potential to save many patients and to ease the fears of the public is substantial. Let us hope that the medication is approved soon. One of the scientists who have been working on remdesivir for years, Maria Agostini of Vanderbilt University sums it up well, "We’ve done a lot of work in coronaviruses with remdesivir, but the big question is: does all of that data that we’ve generated in SARS and in MERS and in MHV, our model coronavirus, does that translate to this new virus?"
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