Remdevivir Fauci what this means

[judeling]

Link to tweet

This was a real study. Results were important enough that the independent monitoring committee had an ethical obligation to inform the control group.

This is good news, it is not game changing news.
What this study shows that there is a real possible treatment possible. That the drug performed in the way it was expected shows that the virus is able to be attacked. It also allows for the possibility that combinations of drugs can become an effective treatment.

But Fauci is being very careful to do is while allowing hope, tempering it with reality.

But what this really does right away is offer the possibility that this drug can, by reducing time, increase our hospitals capacity to care for the ill.

[OilemFirchen]

1. That's right.

The results, such as they are, potentially show that the virus is not unassailable. This drug would appear to be a palliative treatment - not insignificant, but not (as of yet) curative.

[ananda]

2. Agree. It's mitigative effect will save lives.

..

[OilemFirchen]

4. It could.

We have so little information at this point. If the four-day window prevents critical patients from the need for intubation, or if the intubation duration is shortened, then lives will clearly be saved.

I'm happy to wait for more data.

[Towlie]

3. If it cures COVID-19 then it deserves a much cooler name!

[matt819]

5. And, not to sound like a broken record. . .

What's it cost, and who pays?

One article says that the cost of the drug would be 750% of the cheapest basic flu shot, which a chart on that link shows as just over $12.00. So, that's $90 or so. Maybe not so bad, and maybe insurance would cover it. Or maybe not. And what about those without insurance. Will it be like going to CVS and getting the season flu shot for free?

Or will it be pricey. Another anti viral, peramivir, is just under $1,000 per dose.

And Big Pharma is not known for reining in prices. And you know that this regime will do nothing to counter price gouging.

So, we have no idea whether it will work, how long it will take to be widely available, how widely available or affordable will it be?

And, as another DUer pointed out earlier today, we still don't have a vaccine/cure for the common cold. What make us think that a cure for a new and mutating virus will have a vaccine quickly?

[ProfessorGAC]

9. Insurers Like These Treatments

Generally speaking.
The monetary benefit to a $90 shot is way cheaper than the alternative should a patient get deathly ill.
That's why they are mostly willing pay for flu shots. Hospital stays are way more expensive than a flu shot.

[mopinko]

11. conversely, they will charge as close as possible to what the woulda number is.

it's disgusting the way it works, but it is the way it works.
find a cheaper, better way to do something, then price a little less than that, rather than have anything to do w what it costs. sooo much gravy in medical pricing.

[ProfessorGAC]

13. No Doubt

But, those same tactics apply to the more expensive things.
It's not just cash in, cash out, and keep the leftovers.
Insurance companies lend that premium cash out.
The more than keep outflow modest by paying for prevention, the longer that revolving line of credit money bear fruit.
Even if they eventually pay out, profit goes up. Hence, preventative treatments are good for their bottom line.
Now, whether it's productive and useful to have a layer of profit taking for money shuffling is a wholly different matter

[judeling]

10. There are other drugs that attack in the same way

so competition may keep the price down.
But even so $90 when compared to the price of a hospital bed, a 30% reduction in stay time is a huge money saver.

[Yavin4]

6. This is the same approach to HIV/AIDs

A combination of drugs that keeps people alive. Not a full cure mind you. But the death rate is far lower.

[uponit7771]

8. +1, Fauci admitted the CFR change wasn't significant enough

[uponit7771]

7. Its good direction but not a game changer without the knowledge of the sickness level of the

... patients.

If the length of time went from 15 days to 11 with people who weren't that sick that's good but oh well,

It doesn't reduce CFR that much but does show something, I'd take it if the NIH says its safe.

We'll see, I'm waiting on NIH report

[Caliman73]

12. Here is the problem I see with this. It is Trump. It is ALWAYS Trump.

Trump will take this information and start saying, "It's over folks!! I did it!! I stopped the virus!" He will say, "This new beautiful, perfect drug has outsmarted the virus finally so we can all get back to our lives. It powerfully stops the virus and thanks to my efforts we have more of the drug than ever in the history of the world! and if you want it, you can get it at any time!"

Trump is going to fuck this up by jumping the gun and talking all kinds of shit. AND no one is going to stop him. They are all going to sit like quiet little mice and go about their business.

I would love to see this as a positive thing because I am tired of being stuck at home, but I cannot. Not with that asshole in the White House. Mark my words. Trump is going to blast this preliminary, cautious information out there like we now have "the miracle cure".

[SaschaHM]

14. This is great news, but I'd like to see some production/distribution numbers from Gilead as well.

There's still that hurdle of making and distributing enough of this treatment.

[DrToast]

15. They've been accelerating manufacturing for a few months now

The thing is that it's a slow process to manufacture the drug. Here's what they estimate:

-More than 140,000 treatment courses by the end of May 2020
-More than 500,000 treatment courses by October 2020
-More than 1 million treatment courses by December 2020
-Several million treatment courses in 2021, if required

https://www.gilead.com/purpose/advancing-global-health/covid-19/working-to-supply-remdesivir-for-covid-19

However, they also recently learned that a 5-day course is just as effective as a 10-day course, so you can double those figures above.

[SoonerPride]

16. It sure looked like very modest gains. Like a 4% decrease in mortality.

Which that is better than nothing, but isn't exactly a miracle cure or anything.

[judeling]

17. Not statistically significant but 8% vs 11%

is huge.
The study was targeted on treatment time. That there is a class of possible agents that can dramatically change that is good news.
There are other agents in the process of study that may be even better. Then the combinations will be coming.

The best case is a vaccine in about a year. Short of that any treatment at all that mitigates in anyway is a true advance.

The really terrifying thing is we do not actually know if immunity is possible or if it is so temporary that even induced herd immunity of a vaccine is only a very temporary mitigation strategy.

[DrToast]

20. I just missed "statistical significance "

There is basically a 5.9% possibility the decrease in deaths was just due to chance. If it was lower than 5%, it would be considered statistical significant. But it's kind of an arbitrary cutoff.

A different study could show it over the threshold.

[Rstrstx]

18. It IS a promising drug, problem is it has to be given as a shot for several days

So basically it's for hospital patients.

Until we get a vaccine we need a drug/s that can be taken at the onset of symptoms to minimize the disease. The chloroquines were touted as potential candidates but we're still waiting on clinical trials centered on early intervention - they don't seem to help advanced patients.

I have the highest hopes for Avigan, early results are more promising than the chloroquines and it's less toxic, but Fuji won't have their clinical results ready until June (hopefully other trials will be out sooner). It will also take a while to get production numbers up.

Right now the best advice I've heard for infected people is to keep monitoring their oxygen levels using an oximeter and get them to the hospital when their levels start dropping. Many people who currently present themselves at the ER have very low oxygen levels and a lot of damage has already been done, I've heard if doctors can catch people before their oxygen levels drop too low there is a much higher likelihood of survival.

[Dem2]

19. Remdesivir

Been following this for a while since they leaked positive results, then said it wasn't effective, and now it's being tilted as positive again.

We'll see, hopefully it's good that Fauci mentioned it.

[Shermann]

21. I can't say I'm reassured by the comparisons with AZT

AZT took what, a decade of refinement to get where it is? Which is still not a cure?

We don't have that much time. This is a very different virus with the potential to infect half the population quickly.

This feels like a bit of a "good news bone" being thrown without a lot of meat on it.