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How remdesivir works, and why it's not the ultimate coronavirus killer
- gmantg 6y agoIf it costs $1M, I'd rather pick the WC virus.
- smeyer 6y agoIt looks like it will cost a few thousand dollars [0]. What does WC in "WC virus" stand for? [0] https://www.cbsnews.com/news/gilead-coronavirus-treatment-remdesivir-private-insurance-cost/ https://www.cbsnews.com/news/gilead-coronavirus-treatment-re...
- qzw 6y agoPresumably “Wuhan Corona”? I don’t know if that’s common nomenclature in his circle or just idiosyncratic.
- gmantg 6y agoIt's an acronym for Wuhan Coronavirus. There are many coronoviruses and it's natural to use the place of origin to distinguish it from others. This is how we name other species and things in general. In science this is called binomial nomenclature.
- malwarebytess 6y agoWuhan China I'm sure. Poster's objective is probably not to different from those who insist on "China Virus."
- rsynnott 6y agoIt’s a virus you get off toilets, obviously. Hepatitis A, perhaps.
- GuB-42 6y agoIt doesn't cost a million. But me too, I will pick the virus over the million. Obviously because I don't have the million but with a massive loan for the rest of my life, it may not be impossible. So time to pull out the micromorts. Case fatality rate for COVID-19 is estimated to be about 1.4% (still uncertain). That's 14000/1000000 chance of death, or 14000 micromorts. Studies in the US have shown that people are ready to pay ~$50 per micromort. If we assume that remdesivir really is the ultimate coronavirus killer, it means that following statistics, people would pay $700k for it. Not that far off from your million. In reality, safety standards in the US put the micromort at around $10, so that miracle cure would be about $140k. Of course, it is just general statistics, a wealthy old man will pay much more than a poor kid (risk of death increase with age). It assumes remdesivir is a miracle cure, which isn't, we are not sure if it is effective at all. In reality, it looks like treatment is going to be around $3000, which, if it improves my chances of survival by a few percent, is actually a sensible price.
- perl4ever 6y ago>In reality, it looks like treatment is going to be around $3000, which, if it improves my chances of survival by a few percent, is actually a sensible price. But will you pay $3000 for each and every thing that improves your chance of survival by a few percent?
- GuB-42 6y agoDefinitely not when put that way, but it is actually not that far fetched. For example, spending $3000 more for a safer car is not uncommon. Insurance premiums, cost of installing guard rails on your balcony or securing your electrical installation, buying protective equipment, etc... Plus what you pay so that the government can make roads safer, to have water that is safe to drink and food that is safe to eat, etc... That's a lot of $3000 in the end.
- perl4ever 6y agoIf an American household is already paying for all that safety, then reducing risk presumably means additional $3000 "chunks of safety". And if there are double digits of possible risks, then it's prohibitive.
- claudeganon 6y agoIIRC, Gilead has tried to pull this drug off the shelf as a cure multiple times, for different diseases, only to have it proven to not be very efficacious. As soon as they announced it as a COVID treatment, I assumed it was another cash grab while people are confused, desperate, and scared.
- s1artibartfast 6y agoThat seems like a pretty cynical take. My understanding is that Gilead has been donating the drug and provided a royalty free license to other pharma companies to manufacture it (not that they could).
- claudeganon 6y agoThey just announced something like a 7K per treatment price schedule for the drug, and it was largely developed at tax payer expense through a DoD scheme, so I’ll stick to my skepticism. The WHO also accidentally released some study data showing that drug showed no improvement in COVID outcomes: https://www.statnews.com/2020/04/23/data-on-gileads-remdesivir-released-by-accident-show-no-benefit-for-coronavirus-patients/ https://www.statnews.com/2020/04/23/data-on-gileads-remdesiv...
- ethbro 6y agoThe financial justification for antivirals is terrible, given alternatives. Hence why we have so few. So whether the DoD or whatever government branch catalyzed progress doesn't matter much to me.
- s1artibartfast 6y agoI agree that any price is too high if it simply doesn't work. I don't find the public funding critique particularly compelling because it is exactly what the public signed up for. The we fund private medical research and development because we want the more products brought to market by those firms. The reward is that the product exists at all. I do think that there is a compelling argument for the the government trying to do more drug development and then licensing or open-sourcing the product.
- kens 6y agoThere's a nice diagram from Science that shows how Remdesivir and other potential anti-coronavirus drugs work: https://science.sciencemag.org/content/sci/368/6493/829/F1.large.jpg https://science.sciencemag.org/content/sci/368/6493/829/F1.l...
- acqq 6y agoThe picture is from https://science.sciencemag.org/content/368/6493/829 https://science.sciencemag.org/content/368/6493/829 published "22 May 2020" at the time when less was known about Chloroquine and hydroxychloroquine than today about treating Covid-19 (1). That's the needed perspective when watching the picture, where the rest is still relevant. ----- 1) E.g. June 23, 2020 "NIH: Trial Investigating Hydroxychloroquine for COVID-19 Stopped" https://www.empr.com/home/news/hydroxychloroquine-trial-halted-unlikely-to-benefit-covid19-patients/ https://www.empr.com/home/news/hydroxychloroquine-trial-halt... 17 June 2020 "“Solidarity” clinical trial" https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments https://www.who.int/emergencies/diseases/novel-coronavirus-2... "hydroxychloroquine does not result in the reduction of mortality of hospitalised COVID-19 patients, when compared with standard of care." And before, Jun. 9, 2020: "Three big studies dim hopes that hydroxychloroquine can treat or prevent COVID-19": https://www.sciencemag.org/news/2020/06/three-big-studies-dim-hopes-hydroxychloroquine-can-treat-or-prevent-covid-19 https://www.sciencemag.org/news/2020/06/three-big-studies-di...
- jakeogh 6y agohttps://aapsonline.org/preliminary-injunction-sought-to-release-hydroxychloroquine-to-the-public/ https://aapsonline.org/preliminary-injunction-sought-to-rele... more: https://news.ycombinator.com/item?id=23405435 https://news.ycombinator.com/item?id=23405435 and: https://defyccc.com/another-junk-anti-hydroxychloroquine-study-2/ https://defyccc.com/another-junk-anti-hydroxychloroquine-stu...
- acqq 6y agoFrom that link: "AAPS files with the court a chart showing how countries that encourage HCQ use, such as South Korea, India, Turkey, Russia, and Israel, have been far more successful in combatting COVID-19 than countries that have banned or discouraged early HCQ use, as the FDA has." However: that chart is totally misleading, it's a typical "non sequitur". "Case fatality rate" is just a ratio "death" through "cases". Where those with weaker symptoms are recognized as "cases" the rate is lower. How they are recognized is not the same across different countries.
- pazimzadeh 6y agoNucleoside analogs are notorious for breeding resistance, which is why they should ideally be used in combo with other drugs.
- redis_mlc 6y agoIf I was going to choose a potion, I think I'd stick with garlic. Old-school, but can be labelled organic in 2020. You should check out the Youtube videos on plague in the 1500's. Exactly like the response to corona today - it's eerie. Just like China welded residents in their apartments, they used to nail your doors shut. Oh, and the 1%ers ran for the hills, too.
- SomeoneFromCA 6y agoI am wondering, Wikipedia claims that the active metabolite of this drug is a medicine for cats sold on black market; what is the price? I am sure it is way less than the ridiculous price they want for Remdesivir.
- catalogia 6y agoBlack market cat drugs? Do you have a death wish or something?
- SomeoneFromCA 6y agoSometimes you have no choice, I guess.
- lisper 6y agoPeople using fish antibiotics on themselves is a thing: https://www.thebugoutbagguide.com/fish-antibiotics-for-humans/ https://www.thebugoutbagguide.com/fish-antibiotics-for-human...
- kinkrtyavimoodh 6y agoA chemical is a chemical. And people close to dying can be desperate.
- catalogia 6y ago> a chemical is a chemical Is it actually the chemical though? 'Blackmarket pet drug' is the perfect storm of poor accountability. Who the fuck knows what it actually is?
- whymauri 6y agoI mean, if there's an MSDS, verified structural information, etc, then anyone can know what it is.
- HarryHirsch 6y ago
- remote_phone 6y agoThe biggest problem with remdesivir is that it is administered intravenously. That makes it very hard to administer unless the patient is in the hospital. What would be ideal is if they had it in pill form, and then anyone with early symptoms could get pills instead. But without that option right now it makes it too late to administer unless the patient is already in severe condition. They are planning on testing an inhalant version but who knows where that will land in terms of effectiveness. It might make things worse so that is much further out unless things are really lucky, which we haven’t had a lot of with coronavirus.
- Icathian 6y agoHome infusion medicine is a fairly big, and growing, option in the States. A drug being IV is definitely inconvenient, but there are some options.
- systemvoltage 6y agoCurious, how does that work?
- Icathian 6y agoYour physician prescribes an IV medication, and refers you to either a hospital, clinic, or a home infusion provider depending on a variety of circumstances. If you end up with a home IV provider, they process your prescription, ship the drug to your house in a refrigerated container, and schedule a nurse to come out and infuse you. The nurse brings and leaves any supplies you might need.
- vmurthy 6y agoInteresting. Curious to know any FDA approvals for the process or the infusion of this drug? I am curious how the act of processing the prescription and refrigeration can be done safely without compromising the drug itself