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A vial of remdesivir is shown during a news conference in Hamburg, Germany, on April 8, 2020.POOL New/Reuters

Gilead Sciences Inc. on Monday priced its COVID-19 antiviral remdesivir at US$2,340 per patient for wealthier countries and agreed to send nearly all of its supply of the drug to the United States over the next three months.

The price tag is slightly below the range of US$2,520 to US$2,800 suggested last week by U.S. drug pricing research group the Institute for Clinical and Economic Review after British researchers said they found that the cheap, widely available steroid dexamethasone significantly reduced mortality among severely ill COVID-19 patients.

Remdesivir is expected to be in high demand as one of the only treatments shown to alter the course of COVID-19. After the intravenously administered medicine helped shorten hospital recovery times in a clinical trial, it won emergency use authorization in the U.S. and full approval in Japan.

For U.S. patients with commercial insurance, Gilead said it will charge US$3,120 for a five-day treatment course, or US$520 per vial. That is a 33-per-cent increase over the US$390 per vial Gilead said it will charge governments of developed countries and U.S. patients in government health care programs.

In an open letter, Gilead chief executive Daniel O’Day said the price is well below the value it provides given that early hospital discharges could save around US$12,000 per patient in the U.S.

Patient advocates such as Public Citizen argue that the cost should be lower since remdesivir was developed with financial support from the U.S. government.

Peter Maybarduk, director of Public Citizen’s Access to Medicines Program, called the price “an offensive display of hubris and disregard for the public.” While the drug modestly reduced hospital stays, it has not been shown to reduce deaths in COVID-19 patients.

Gilead also said it agreed to continue to send its supply of remdesivir to the U.S. Department of Health and Human Services (HHS), with the agency and states set to manage allocation to U.S. hospitals until the end of September.

HHS said it secured more than 500,000 remdesivir courses for U.S. hospitals through September, which represents all of Gilead’s projected production for July and 90 per cent of its production in August and September, in addition to an allocation for clinical trials, HHS said.

Once supplies are less constrained, HHS will stop managing the allocation, Gilead said. The company did not discuss its supply strategy for developed countries outside the United States.

Remdesivir’s price has been a topic of intense debate since U.S. regulators approved its emergency use in some COVID-19 patients in May. Experts have said Gilead would need to avoid appearing to take advantage of a health crisis for profits.

Gilead shares were about flat in midday trading.

The European Union’s health care regulator last week recommended conditional approval of the drug when used in the critically ill. The formal go-ahead by the European Commission is expected to follow soon.

Gilead has linked up with generic drugmakers based in India and Pakistan, including Cipla Ltd and Hetero Labs Ltd, to make and supply remdesivir in 127 developing countries.

Cipla’s version is priced at less than 5,000 Indian rupees (US$66.24), while Hetero Lab’s version is priced at 5,400 rupees.

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