High cost of COVID treatments

by Rey Gamboa – The Philippine Star, 14 Sep 2021

For people who have or have had a kin hospitalized for COVID-19, one of the biggest worries is the scarcity of the prescribed medicines – and if one is able to find what the doctor ordered, the shockingly prohibitive cost.

Remdesivir, for example, which is one of the most popular recommendations for treatment, can go for the maximum allowable retail price of P8,200 for a 100mg vial. A patient will usually need a prescription of one vial a day for four days or until discharged from the hospital.

Tocilizumab, an aggressive treatment for patients with complicating pneumonia, on the other hand, can go for as much as P75,000 a vial when supply is tight, although the Department of Health has imposed stiff penalties on anyone caught selling the drug for higher than P25,000 a vial.

The cost of these medicines taken intravenously is just the tip of the iceberg. Tally up hospital care, and patients in intensive care suffering from severe COVID are likely to succumb to anxiety attacks if they take their daily billings to heart.

It’s like renting a taxi, not one with four wheels, but one with rotor blades, on a daily basis until the patient is well enough to move to a regular room, says one friend. Even patients’ families admitted in government hospitals feel the pinch despite state subsidies, which often do not cover for everything.

The cost for vaccinated patients who manage to dodge admission in the ICU should be expectedly lower, but it could still cost an arm and a leg, especially among those whose livelihoods have been badly screwed because of the lockdowns.

Truly, this pandemic has taken a toll on the health and wealth of the country. For this reason alone, extra effort must be expended to find cheaper ways to protect people from this deadly virus.

Vaccine ‘protection’

Today’s approved vaccines against COVID-19, without doubt, offer comforting levels of protection from getting seriously ill – but not from being infected.

Breakthrough infections, defined as having COVID-19 despite full immunization, are no longer isolated cases. Those who get sick are often assigned to home care, where healthcare personnel provide tele-consultation services to monitor the patients’ progress.

While recovery is, less costly than admission in a hospital, treatment still carries a price, which would include being on sick leave from employment for one or two weeks. For daily-wage workers who are not paid when they don’t clock in, vaccination does not offer livelihood protection.

Thankfully, we’re seeing a greater push now to find another way to beat this virus without having to worry about emerging variants that are deadlier and more transmissible while waiting to achieve the increasingly difficult goal of world herd immunity.

Big pharma is now looking at antiviral concoctions to treat infections while blocking viral replication, the latter being seen as a weakness of available COVID-19 vaccines, even those that offer 90 percent “protection.”

Oral anti-virals

Receiving more attention from the media are COVID-19 vaccine maker Pfizer and multinational drug company Merck, who have announced clinical studies on oral antiviral medicines.

Merck is keen to introduce a medication that prevents adults from getting infected even when sharing the same household with a confirmed COVID-19-positive person. Pfizer’s is a get-well drug for persons who catch the virus, but are not at risk of severe illness.

Elsewhere, there’s Japanese drug maker Shionogi & Co. that’s touting the efficacy of a pill that attacks the coronavirus in early stage infections. For those with severe respiratory infections, an Israeli study is banking on an FDA-approved anti-viral drug that has rapidly stopped deterioration of a patient’s condition at only a fraction of the cost of Remdesivir, Tocilizumab or others currently recommended in hospital care.

Prophylactic route

The shifting views on COVID-19 response should be enough to encourage our government to keep its options open to new approaches. Prophylactic care, in particular, focuses on keeping the body’s immune system impervious to viral attacks.

Of the more controversial prescriptions to date, Ivermectin wins hands-down. A popular and cheap drug used by Africans to cure river blindness decades ago, it has been submitted to the World Health Organization as a repurposed cure to prevent the deadly coronavirus from attaching to humans.

The Philippines is one of the countries that has joined several others in a global consortium that seeks to end once and for all the skepticism displayed by international health institutions despite the growing number of adherents among both medical professionals and users.

Leading the Ivermectin trials in the Philippines, which is scheduled to conclude early next year, is the Department of Science and Technology with the Philippine Council for Health Research and Development (DOST-PCHRD).

DOST is also deep into finding other alternative prophylactic treatments indigenous to the country, such as lagundi and virgin coconut oil (VCO). Such approved studies are being done in partnership with hospitals and university-based research bodies.

Ivermectin, lagundi, VCO, and other similar potentially prophylactic agents against COVID-19 deserve more support because they represent infinitely less costly alternatives to prevent the spread of the deadly virus or as an early cure.

With vaccines still in tight supply, and with the possibility of booster shots being adopted in many developed economies, countries in developing countries should realize that they can only rely on themselves to survive this pandemic.

We should have prophylactic kits, much like what India is doing now, that has supposedly helped bring down their infection and death rates to much more respectable levels.