Estimating the cost of Covid-19 antiviral development

Money will of course be no object when it comes to funding development of treatments for Covid-19, but how much exactly are we talking?

A lot of time and resources are being thrown at developing treatments for Covid-19, with governments around the world pledging to spend whatever it takes to find a treatment. Much of the initial expense will fall on biopharma companies, however.

To estimate how much these investigations might cost, Vantage has extracted estimates from EvaluatePharma Vision and looked at historic precedent, for the development of vaccines and antivirals in previous pandemics.

Phase III trials of Gilead’s remdesivir are likely to be the most expensive ventures right now; the US biotech has indicated that initial data should emerge before the end of March. This readout represents the world’s nearest-term chance of finding a treatment for the sometimes deadly respiratory symptoms caused by this particular coronavirus.

According to EvaluatePharma Vision’s R&D Costs module, these trials will probably cost Gilead around $150m to run. Estimates of the phase III trials being run in China are also included – the much lower figures reflect the fact that it is substantially cheaper to run studies in this region. A description of how these costs are calculated is below.

Gilead can afford this, of course, and should remdesivir prove effective the commercial return is likely to be huge, notwithstanding the company claiming their efforts are not rooted in the commercial. Roche has booked cumulative sales of $15.9bn of Tamiflu since it was launched in 1999; annual sales peaked at just over $1bn in 2014. These figures exclude sales booked by the other companies that make it 

A previous Vantage analysis, looking at historic sales of flu antivirals, shows how much these drugs brought in for their developers (Previous pandemic antiviral demand spike sees Biocryst jump aboard, March 5, 2020).

Coronavirus costs – antiviral development 
Details  Estimated cost of trial ($m)* NCT ID 
US sponsored studies 
Moderate Covid-19 disease, remdesivir vs SoC (n=600) 92 NCT04292730
Severe Covid-19 disease, two remdesivir regimens (n=453) 61 NCT04292899
NIAID-sponsored adaptive Covid-19 treatment trial (n=394) 88 NCT04280705
Chinese sponsored studies 
Severe Covid-19 respiratory disease (n=453) 31 NCT04257656
Mild-moderate Covid-19 respiratory disease (n=308) 21 NCT04252664
Estimated total clinical costs of developing Tamiflu  300 -
Estimated total clinical costs of developing Relenza 393 -
SoC = standard of care. Source: EvaluatePharma Vision.

*EvaluatePharma Vision's R&D cost model estimates the cost of individual clinical programmes using real-world data. Company disclosed product-level spend and clinical trial patient numbers are combined to create cost per patient benchmarks by technology and therapy type. Utilising a matching algorithm, these benchmarks are applied to all commercially relevant clinical trials to estimate their cost, which can then be aggregated by product to estimate the cost of development of all products. 

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