Setting the price of a treatment, “a difficult exercise in the midst of a coronavirus pandemic”

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At the entrance to Gilead's headquarters in Foster City, California on April 29.

Pertes & profits. The sick, health insurance and governments are in ambush, and pharmaceutical companies know they are walking on a perilous crest line when they set a price for their treatments – especially during a pandemic: too high, and it’s is being accused of profiting from the misery of the world; too low, and it is losing money, which is hard to imagine, whether the company is listed or not.

The American Gilead Sciences is one of the first to comply with this difficult exercise in the midst of the global crisis linked to the Covid-19 pandemic. He announced Monday, June 29, that he will offer a five-day treatment with remdesivir at a price of 2,340 dollars (2,083 euros) in developed countries. And four times less in the 127 poor or emerging countries, where laboratories will be able to produce it in the form of a generic. Like Brazil, hard hit by the health crisis. “We are in unknown territory with the price of a new drug in a pandemic”, admits the CEO of the California laboratory, who says he wants “All patients benefit worldwide”.

Article reserved for our subscribers Read also Covid-19: The United States Authorizes Remdesivir-Based Treatments

Daniel O’Day argues that remdesivir reduces the average length of hospital stay by four days (eleven days). Or, he says, a saving of 12,000 dollars in the United States, where hospital bills are exorbitant. Some analysts believe that Gilead could have doubled its price ($ 4,500-5,000). The Institute for Clinical and Economic Review, a non-profit organization that assesses the price / effectiveness of drugs, judges the price selected to be in line with its assessments. Others, on the contrary, estimate its fair price at 320 dollars. Especially since he did not provide proof that he reduced mortality.

Indignation

Without waiting for the deployment of remdesivir from July, this price is already arousing the indignation of consumer associations. They judge him “Outrageous” taking into account the aid from the American government and its low manufacturing costs. “One dollar per injection”, therefore recommends Public Citizen. “Unrealistic”, replies Daniel O’Day. His company should take advantage of this molecule, one of the few to have proven effective against Covid-19, which has already infected 10 million people and killed more than 500,000.

It is not sure, however, that it is a cash machine: many laboratories are deploying large resources to develop other treatments and vaccines that could store the remdesivir at the bottom of the medicine cabinet. Gilead’s relative restraint is a signal sent to other laboratories, tempted to take advantage of the pandemic to inflate their prices. If there is no perfect price for drugs, they must also reflect research and development efforts, with their share of often costly failures. Even if we tend to consider that all treatment is a global public good to be excluded from market forces.

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