Minimum manufacturing costs, national prices, and estimated global availability of new repurposed therapies for coronavirus disease 2019
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Author(s)
Wang, Junzheng
Levi, Jacob
Ellis, Leah
Hill, Andrew
Type
Journal Article
Abstract
BACKGROUND: Currently, only dexamethasone, tocilizumab, and sarilumab have conclusively been shown to reduce mortality of coronavirus disease 2019 (COVID-19). Safe and effective treatments will need to be both affordable and widely available globally to be used alongside vaccination programs. This analysis will estimate and compare potential generic minimum costs of a selection of approved COVID-19 drug candidates with available international list prices. METHODS: We searched for repurposed drugs that have been approved by at least one of the World Health Organization, US Food and Drug Administration, or the United Kingdom National Institute of Health and Care Excellence organizations or at least given emergency use authorization or recommended for off-label prescription. Drug prices were searched for dexamethasone, budesonide, baricitinib, tocilizumab, casirivimab, and imdevimab, and sarilumab, using active pharmaceutical ingredients (APIs) data extracted from global shipping records. This was compared with national pricing data from a range of low-, medium-, and high-income countries. Annual API export volumes from India were used to estimate the current availability of each drug. RESULTS: Repurposed therapies can be generically manufactured for some treatments at very low per-course costs, ranging from US $2.58 for intravenous (IV) dexamethasone (or US $0.19 orally) and US $4.34 for inhaled budesonide. No export price data were available for baricitinib, tocilizumab, casirivimab, and imdevimab, or sarilumab, but courses of these treatments have higher prices, ranging from US $6.67 for baricitinib to US $875.5 for sarilumab. When comparing international list prices, we found wide variations between countries. CONCLUSIONS: Successful management of COVID-19 will require equitable access to treatment for all populations, not just those able to pay high prices. Dexamethasone and budesonide are widely available and affordable, whereas monoclonal antibodies and IV treatment courses are more expensive.
Date Issued
2022-01
Date Acceptance
2021-11-17
Citation
Open Forum Infectious Diseases, 2022, 9 (1)
ISSN
2328-8957
Publisher
Oxford University Press
Journal / Book Title
Open Forum Infectious Diseases
Volume
9
Issue
1
Copyright Statement
© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases
Society of America. This is an Open Access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/
licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the
work, in any medium, provided the original work is not altered or transformed in any way, and that
the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
https://doi.org/10.1093/ofid/ofab581
Society of America. This is an Open Access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/
licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the
work, in any medium, provided the original work is not altered or transformed in any way, and that
the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
https://doi.org/10.1093/ofid/ofab581
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34988252
Subjects
access to medicine
COVID-19
drug availability
drug prices
drug repurposing
Publication Status
Published
Coverage Spatial
United States
Article Number
ofab581
Date Publish Online
2021-12-17