Manufacturing Costs of Potential COVID-19 Drugs as Low as $1

Repurposed generics show promise as potential COVID-19 drugs and may be manufactured profitably at very low costs, according to a recent study. 

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The study posted in The Journal of Virus Eradication uncovered that costs of production ranged between $0.30 and $31 per treatment course, which was between 10 and 28 days. Current prices of these drugs were higher than the costs of production, particularly in the US.

Specifically, minimum costs of production were US $0.93 a day for remdesivir, $1.45 a day for favipiravir, $0.08 a day for hydroxychloroquine, $0.10 a day for azithromycin, $0.28 a day for lopinavir/ritonavir, $0.39 a day for sofosbuvir/daclatasvir, and $1.09 a day for pirfenidone. 

Lower income countries will need access to these treatments at affordable prices to ensure individuals can be treated. Even in high-income countries, the burden of disease could be so great that access to drugs at minimum costs could also be necessary, researchers stressed.

The leading candidate drugs to treat COVID-19 were selected based off reviews and analyses of ongoing clinical trials. Experts found that the current prices of these drugs were significantly higher than cost of production, particularly in the US.

Researchers estimated the minimum costs of production from the costs of active pharmaceutical ingredients using an established methodology with good predictive accuracy for medicines for hepatitis C and HIV amongst others, the study stated. Researchers took data from global export shipment records or analyses of the route of chemical synthesis. The estimated costs were compared with list prices from a range of countries where pricing data was available.

“Repurposed drugs may be our only option to treat COVID-19 for the next 12–18 months, until effective vaccines can be developed and manufactured at scale. If repurposed drugs do show efficacy against COVID-19, they could be manufactured at very low unit prices, in the range of $1 to $29 per treatment course,” researchers said in the study. 

“The system of mass production and distribution of drugs to treat HIV, TB and malaria via GFATM and PEPFAR could act as a blueprint for the treatment of SARS-CoV2, to ensure access to effective drugs at low prices worldwide.”

Of the many ongoing clinical trials, experts leaned towards hydroxychloroquine as one of the most promising potential coronavirus treatments. 

Last week, Henry Ford Health System announced it would lead the first large-scale study in the US to determine the effectiveness of hydroxychloroquine in preventing COVID-19 among healthcare workers and first responders. 

Enrollment for the study of the anti-malarial drug, titled “WHIP COVID-19 Study,” began at the end of last week. The study received more than 1,000 volunteers and interim results are expected in 30 days. Final results of the trial are expected in the summer. 

Hydroxychloroquine is currently an FDA-approved arthritis medicine that is also used to treat malaria. Experts have talked about the drug as a COVID-19 treatment, but further studies and trials will be conducted to uncover if it’s effective against the rapidly spreading novel coronavirus. 

Along with hydroxychloroquine, remdesivir has been evaluated for treatment of coronavirus. There are currently five clinical trials of remdesivir for SARS-CoV2, with results expected within the next few weeks. 

The investigational broad-spectrum antiviral treatment was developed by Gilead Sciences in 2013. Experts believe it is one of the most promising drug treatments against COVID-19. 

Remdesivir has demonstrated in vitro and in vivo activity in animal models against MERS and SARS. These diseases are structurally similar to COVID-19. The limited data researchers have indicated that remdesivir may have potential activity against coronavirus. 

Unlike both hydroxychloroquine and remdesivir, lopinavir showed no significant benefits in patients with severe COVID-19 compared to standard care, according to a clinical trial launched at the end of March. 

Although mortality at 28 days was similar in the lopinavir-ritonavir group and the standard care group, lopinavir patients saw one less day for clinical improvement at 15 days, compared with 16 days in the standard-care group.

Because of the modest improvement period, patients in the lopinavir-ritonavir group had a shorter stay in the intensive care unit (ICU) than those in the standard care group, at six and 11 days, respectively.

Almost half of the 160 patients assessed in the study, 48.4 percent, in the lopinavir-ritonavir group and 49.5 percent in the standard-care group saw gastrointestinal adverse events such as nausea, vomiting, and diarrhea. 

“In conclusion, we found that lopinavir–ritonavir treatment did not significantly accelerate clinical improvement, reduce mortality, or diminish throat viral RNA detectability in patients with serious Covid-19,” researchers highlighted. “These early data should inform future studies to assess this and other medication in the treatment of infection with SARS-CoV-2.”

Pharmaceutical companies continue their search for a COVID-19 cure as the number of confirmed cases continues to soar. But once a drug is found, there is potential for widespread access as drug manufacturing costs remain low.