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Repurposed drugs may be a 'cheap option' to treat Covid-19 patients until a vaccine is developed

A study has shown that a vaccine to protect against SARS-CoV2 may be 12-18 months away from development.

Image: SIPA USA/PA Images

DRUGS USED TO treat other illnesses could be an affordable, “very cheap” way to treat patients with Covid-19 until a vaccine is developed, according to a study published today. 

The general consensus of how long it could take to develop a vaccine against SARS-CoV-2 is 12-18 months, even if current trials are successful.

But, if one of the current clinical trials on drugs to treat those who already have Covid-19 are successful, the manufacturing could be done at “very low prices”.

This cost would be between $1 (90 cents) and $29 (€26) per person per day, according to a study published in the Journal of Virus Eradication 2020 today.

“All the treatments being evaluated in clinical trials are very cheap to manufacture,” the study noted.

In summary, 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.

This analysis also assumed a 10% profit for the mass production of these drugs, which is similar to the pricing structure for HIV, TB and malaria.

As stated above, this analysis is based on one of the drugs being tested in clinical trials demonstrating “significant benefits” for patients; many of these drugs aren’t developed specifically for Covid-19, but to treat other viruses or diseases, such as BCG.

The costs of treatment could be higher if combinations of two or three drugs are needed.

Entitled ‘Minimum costs to manufacture new treatments for Covid-19′, the study analyses the amount it costs to produce a vaccine, with some margin for minimal profit.

Dr Andrew Hill, one of the authors of the study, said in a discussion organised by Access to Medicines Ireland, a group campaigning for a research and medicine system at a fair price, that “we’ve got probably 18 months where we’re almost certainly not going to have a vaccine”.

“So, if these trials work – and we’ve got to we’ve got to remember that’s a big ‘if’, we don’t know which of these treatments is going to prove successful – but we can aim for a target price of approximately one US dollar per person per day and often much less.

“So if these drugs can be mass produced, anyone with coronavirus in any country could afford them,” he said, referencing the system used to treat HIV, TB and malaria that were sold “close to the cost of production to treat millions of people”.

There are currently 41 SARS-CoV2 vaccines in development, which could protect the most vulnerable people from contracting the virus. There are also 23 anti-inflammatories in trial, which could help treat those who have contracted the Covid-19 disease.

Of those looking at vaccine options, Johnson & Johnson has invested $500 million into research and development, with the US government matching that amount. The CEO of Johnson & Johnson has said that the vaccine would be made available for free. 

The BCG vaccine

“I think this is the biggest spotlight shone ever on pharma,” Professor Luke O’Neill of the School of Immunology at TCD said during the Access to Medicine Ireland discussion. “I think the pharma sector will change radically as a result of this.”

He said that the world will be different after this, and also suggested how the BCG vaccine could boost the innate immune system to help fight against Covid-19.

“I’ve worked on BCG for years, if you’re an immunologist, this is bread and butter,” he said. “It’s a fantastically powerful immuno-stimulant.”

It was originally used as the vaccine for TB, when academics noticed that it may also give a type of immunity to measles. After that, they noticed it may also give protection against malaria, and respiratory diseases.

“This vaccine protects against diseases by boosting innate immunity – it puts up a barrier that propels away many germs,” O’Neill said. “It could provide a non-specific boost that will protect you against Covid-19.”

This has provoked many trials on the vaccine’s affect on Covid-19 in Holland, in Australia with healthcare workers, and in Germany with elderly people.

Who should be funding vaccine research?

During that same Access to Medicine Ireland discussion this week, panellists from Medicine Sans Frontieres, patient advocate groups and academics argued that the way medicine research and vaccines are carried out by the private sector might not be working as best it could. 

Diarmaid McDonald of Just Treatment, a UK group campaigning for access to affordable medicines, said that although some have argued that “communism never delivers innovative medicines”, a significant proportion of coronavirus research in the US is funded by the US government. 

“Actually, the entire system of developing medicines in our Western capitalist societies is highly socialised with huge amounts of State and public funding underpinning it.

There wasn’t a single new drug that was approved for use in the US from 2010 to 2016 that didn’t have significant National Institute of Health (US government funding) behind it.

“On coronavirus, 2002 research by Public Citizen [a not-for-profit consumer advocacy group] said there were $700 million or more [worth of] investments that came from the US government on coronavirus research.

At the same time, the four biggest vaccine producers last year alone, they made $30 billion on selling vaccines. The premise being that that generates research to be invested into the future of vaccines that we need as a society, according to the theory of how this model should work.
But actually, in reality, last year we only have six clinical trials for coronavirus treatments and vaccines in operation, all of them with significant public funds. So the current system really is and failing to deliver for us.

He said that despite the huge levels of public investment in vaccines, there’s very little safeguards to guarantee pricing that’s fair, or equal access to those vaccines.

Dr Gaelle Kirkorian of Médecins Sans Frontières said that “the best way to have a fair price is to have access to all data about what it costs to produce the product and to supply the product. We need transparency from the very beginning of the R&D chain.”

Jacqui Browne, a patient advocate for the IHREC Disability Advisory Committee, said that “the public is taking more ownership about becoming informed and trying to learn and understand what is happening”.

“I think this is a time that we should never forget that. As long as we keep bringing all voices and all the players together in an open, transparent way where there is no more hidden conversations behind closed doors, I think it would be far better society and outcome for everybody.”

Kay Curtin, a patient advocate said that “hopefully we won’t be going back to a situation where we have 600 plus people waiting on any given day for a bed in our hospital system”.

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