Combo study of Gilead antiviral, Lilly anti-inflammatory drug positive in Covid-19, but raises pricing jitters

Trials of Gilead's remdesivir in Covid-19 not diverse enough, experts write

On the same day that Eli Lilly announced mixed interim results from the trial of its in-house antiviral drug for Covid-19, positive data from the Phase III study of a combination treatment it is testing of a marketed anti-inflammatory and an antiviral with emergency use authorization from U.S. regulators has raised concerns about a potentially high price tag.
The Indianapolis-based drugmaker said Monday that the Phase III placebo-controlled ACTT-2 trial of Lilly’s Olumiant (baricitinib) combined with Gilead Sciences’ antiviral Veklury (remdesivir) in 1,000 hospitalized Covid-19 patients showed a statistically significant median one-day reduction in time to recovery for patients in the combination arm compared with those in the control group, who received Veklury alone. The trial was sponsored by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. Lilly is also testing Olumiant, a JAK inhibitor normally used to treat rheumatoid arthritis, in the Phase III COV-BARRIER trial, and said it would assess the implications on that trial of the ACTT-2 results. A key secondary endpoint, comparing patient outcomes at day 15 on the eight-point scale ranging from full recovery to death was also met.
Still, an industry analyst suggested cost could be an issue.
“While there is genuine excitement surrounding the use of Olumiant for hospitalized COVID-19 patients, concerns still remain regarding the price of the therapy when combined with Veklury,” GlobalData analyst Patrick Aiyes wrote Wednesday.
Veklury, Aiyes noted, costs more than $3,600 for a five-day course of treatment. Assuming Olumiant’s approval with a 10-day Veklury treatment course, that drug could cost more than $6,600. For 10 days of therapy with both drugs, costs could go up to nearly $8,000, a price he called potentially “prohibitive.”
“Although Olumiant displayed clear efficacy in combination with Veklury, the cost of the therapy could significantly hamper its uptake since inexpensive genericized molecules are already available, such as dexamethasone,” Aiyes wrote.
The company said Wednesday that data from a Phase II study of its in-house monoclonal antibody against SARS-CoV-2, LY-CoV555, reduced viral load in outpatients with mild to moderate Covid-19, though analysts regarded the data as mixed.
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