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Plan to distribute Covid-19 drug unveiled amid concerns over allocation - STAT

WASHINGTON — The federal government on Saturday announced a plan to distribute remdesivir, the antiviral drug used as a Covid-19 treatment, following nearly a week of chaos and confusion surrounding which hospitals and which states would receive the medication, and how they were chosen. 

While some hospitals in recent days had reported receiving allocations of remdesivir directly, others received none, leaving many doctors and hospitals across the country frustrated and in the dark as to when and they might receive supplies.

The federal government’s new plan will deliver the drug to state health departments and allow them to determine which hospitals should receive it. 

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“State health departments will distribute the doses to appropriate hospitals in their states because state and local health departments have the greatest insight into community-level needs in the COVID-19 response,” the Department of Health and Human Services said in a statement. 

Gilead Sciences, the drug’s manufacturer, has committed to donating 607,000 vials of remdesivir to treat roughly 78,000 patients in the next six weeks, the department said. 

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The latest round of remdesivir distributions will send 5,600 vials of remdesivir to Illinois, 4,400 to New Jersey, 1,600 to Michigan, 1,200 to Connecticut and Maryland, and 400 to Iowa. 

Earlier in the week, federal officials had declined to specify which hospitals and states had received remdesivir, and how many vials had been delivered. HHS finally clarified those numbers on Saturday, reporting the delivery of nearly 23,000 vials to New York, nearly 5,000 to Massachusetts, 4,000 to New Jersey, and smaller allotments to Indiana, Virginia, Rhode Island, and Tennessee.

Even in those states, however, the hospitals that received remdesivir were not necessarily those treating the highest numbers of coronavirus patients. 

Though the announcement sheds some light on how the federal government is working to distribute the most Covid-19 treatment, it leaves unanswered other questions about the methodology. 

The federal government’s announcement, for instance, made no mention of California, Pennsylvania, and Florida — meaning the states with the fifth-, sixth-, and eighth-highest Covid-19 case totals, respectively, have not received remdesivir allocations. 

Federal officials expect that all 50 states will eventually receive the drug, as will the Indian Health Service and Department of Veterans Affairs. 

The announcement also made no mention of AmerisourceBergen, the drug distributor that had worked with Gilead earlier in the week to distribute remdesivir to hospitals. 

Doctors and public health officials have called for the federal government to create a transparent system for distributing remdesivir. Some experts have pointed to the website the Centers for Disease Control and Prevention created in 2009 once the Food and Drug Administration authorized peramivir, an antiviral used to treat the H1N1 flu, on an emergency basis. 

The Infectious Disease Society of America on Wednesday penned an open letter to Vice President Mike Pence urging the Trump administration to create a fair and open process for distributing the drug.

The FDA granted an emergency use authorization for remdesivir on May 1, soon after researchers announced positive results from a clinical trial that showed the drug was successful in shortening the number of days it took Covid-19 patients to recover. 

The 607,000-vial donation over the next six weeks represents roughly 40% of Gilead Sciences’ commitment to donate its entire supply of roughly 1.5 million remdesivir doses, as it seeks to ramp up more production. 

Patients will only be eligible to receive the drug if they require supplemental oxygen, a ventilator, or other mechanized breathing support, the FDA said. 

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