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Can the COVID-19 pandemic reconcile Big Pharma and Joe Public?

The COVID-19 pandemic has thrust us into an unfamiliar world with which the pharmaceutical industry has taken centre stage. We are witness to a vaccines arms race the likes of which we have never seen. Pharma share prices soar on the slightest glimmers of hope as the world economy bares its fragility.

Whilst safe and effective vaccines offer the surest way out of the current crisis, treatments for SARS-CoV-2 infection will also play a significant role in reducing mortality and disease severity. Gilead’s remedisivir is one such treatment. Although initially indicated for Hepatitis C, the broad spectrum anti-viral has shown some efficacy against the coronaviruses behind SARS, MERS and now COVID-19.

Following positive study results – reducing the  recovery time of patients with severe infection by 31% on average  – Gilead announced remedesivir’s pricing for a five-day treatment course at $2,340 per patient for private medical insurer’s – slightly less for public health systems.

This announcement was met by the same public vitriol the pharmaceutical industry has been subjected to since its modern inception – Big Pharma is some subversive, intrinsically evil monolith that converts human suffering into shareholder profit by suppressing the cure for cancer, fabricating illegitimate diseases to target with drug after drug, creating the problem to sell the solution. In fact, 1 in 7 Americans, according to one survey, believe the industry is obscuring a “cure for cancer” failing to appreciate the huge complexity and variety of cancers.

Common misconceptions, contemptuous views and more outlandish conspiracy theories have no single origin, but the pharmaceutical industry’s historically opaque and almost elusive qualities have certainly been a factor. Of course, the pharmaceutical industry is not without controversy, but bad actors will malign whatever industry they wind up in. Big Pharma is not the exclusive domain of price fixing, bribery, corner cutting and corruption. But it is the industry that ultimately improves human health, longevity, and quality of life – and these endeavours have a price.

Gilead has poured tens of millions of dollars into remdesivir’s development and manufacture already, and with its sustained evidence of treating severe COVID-19 cases, remdesivir’s manufacturing costs are predicted to soar up to $1b over its lifespan on the market.

The average cost of bringing a drug to market broke $5bn in 2013 and will only increase as research becomes more refined with the aid of artificial intelligence. The drugs that do eventually pass regulatory approval and reach patients after their gargantuan development process not only need to recuperate their own costs, but also the costs of the 9 in 10 drugs that fall at technical, clinical or regulatory hurdles and never see the light of day.

Capitalist arguments aside, the pharmaceutical industry has quietly and frequently shown more altruistic tendencies. Gilead has donated millions of doses of remdesivir to the US, Australia, Japan and others for the patients who need it most.

Millions of people in South America, Africa and Asia are threatened by neglected tropical diseases (NTDs) such as Dracunculiasis, a debilitating parasitic disease in which a female worm 1 metre in length emerges from a blister on a victim’s leg over several weeks, many months after infection . Through a concerted, multi-decadal  effort enshrined in the London Declaration, numerous pharmaceutical companies have collectively delivered over £18b in NTD therapies for free. Most NTDs now face eradication, alongside a significant barrier to economic development in the poorest parts of the world

The industry’s response to COVID-19 has already surpassed even this gargantuan effort, operating in overdrive to deliver therapies and vaccines at record pace. But the lengthy process of bringing a drug to market will always remain enormously risky and capital-intensive. Only private investment or publicly-traded shares can support these endeavours, with the chance of failure and financing required being wholly unpalatable for governments who cannot afford to gamble with taxpayer’s money. We should call out amoral and unethical behaviour in the pharmaceutical industry, as with any other, but that shouldn’t preclude an appreciation or even the slightest acknowledgement that Big Pharma is why we will live better lives, pandemic or otherwise.

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