While remdesivir is not a miracle drug, can it help COVID-19 patients?

By Michael Kinney

The past few weeks there has seemed to be nothing but bad news coming out about the coronavirus pandemic. They include daily reports of spiking number of cases across the country and ICU wards being overrun.

There was one bit of positive news that came out about the antiviral drug remdesivir that many are hoping can turn the tide in the fight against COVID-19. However, Dr. Scott Michener, the Chief Medical Officer at Comanche County Memorial Hospital, isn’t ready to call it a gamechanger yet.

“It’s (remdesivir) an antiviral, and as we know coronavirus is a virus,” Michener said. “It’s not a magic bullet. It’s not some cure all that you get remdesivir and you well, but it has shown some mild benefit against coronavirus. And as it’s the only one, one of our only tools in the shed, it is the one that is getting the use.”

Late last week,  researchers at Vanderbilt University Medical Center, the University of North Carolina at Chapel Hill and Gilead Sciences reported that remdesivir potently inhibited SARS-CoV-2, the virus which causes COVID-19, in human lung cell cultures.

“All of the results with remdesivir have been very encouraging, even more so than we would have hoped, but it is still investigational, so it was important to directly demonstrate its activity against SARS-CoV-2 in the lab and in an animal model of disease,” said VUMC’s Andrea Pruijssers, Ph.D.

According to Michener, the CDC has also been forming tests with remdesivir and has seen strong results.

“I haven’t seen a recent study, but the CDC study when they did give it FDA emergency approval, it showed a decreased hospitalization rate from 14 days to 11 days,” Michener said. “So it got people well a little faster. But there have been some studies that showed that it didn’t make much improvement.”

According to a CNBC report, the findings show that 7.6 percent of patients treated with remdesivir died compared with 12.5 percent of patients who were not on the treatment.  It also showed that 74.4 percent of patients who received treatment with remdesivir recovered by day 14 compared with 59 percent of those not on the antiviral drug. 

While Michener says the results are good, he doesn’t want people jumping the gun and believing remdesivir is some type of cure.

In fact, remdesivir can really only be used in certain situations. That does not include severe COVID-19 patients who may be on the verge of death.

“Antivirals they’re not like antibiotics for bacteria, and so remdesivir’s kind of one of those that if you get it early in the course, if you get it early before the viral load is too high, you probably offer that patient some benefit,” Michener said. “If it’s the fourth quarter, 30 seconds left in the game, and you’re throwing a Hail Mary, it’s probably not going to do much, and so it’s one piece that we have. It’s not a miracle, but it’s better than nothing.”

Because remdesivir has shown to be the only effective drug so far against COVID-19, there has been a run on it around the country. That leaves hospitals not sure how much they can get for their patients.

“The federal government bought a bunch of it. I don’t know if they gave it, or if we bought it, but the state of Oklahoma bought it, so they have controlled all the allocation,” Michener said. “What was happening up until now was when we had a patient that qualified for remdesivir we would fill out a form, send it to the health department, and with their approval, they would deliver us the remdesivir. Well now, as of this morning’s development, they can’t keep up because hospital admissions are going up, demand’s going up.”

Michener was on a remdesivir allocation conference call Thursday discussing the problem and solutions to how the system will work going forward.

“So their new allocation manner is, they’ll give you a supply based on your last seven to 14 days of usage. So they’ll give us a supply that we will house, and we will use, and then they’ll replenish until the supplies are gone,” Michener said. “ One of the questions I asked the guy was, “When will the supplies be gone,” and he said he couldn’t tell me that because the curve is bending upwards, and so it’s hard to predict what’s going to happen. It’s hard to predict what’s going to happen tomorrow, much less next week.”

According to Michener, the company that made remdesivir (Gilead Sciences) has priced it around $4,000 per patient per treatment course.

“I don’t know if the state bought these doses or these are the donated doses the company gave to the federal government,” Michener said. “I think at some point this is going to run out, and then it’s going to be probably more to a current medication distribution system like we have, is that your pharmacy orders it, and we buy it, and we get it rather than go through the state. But I can’t speak to the details of exactly when or what that picture looks like.”

Story by Michael Kinney/Michael Kinney Media

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