Remdesivir Shipments Decided By Secret Federal Formula : Shots - Health News The federal government is in charge of distributing one of the few treatment options for COVID-19: the antiviral drug remdesivir. But how are decisions made about which states need it most?

How Feds Decide On Remdesivir Shipments To States Remains Mysterious

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The federal government is in charge of distributing one of the few treatment options for COVID-19, a drug called remdesivir. But how does the federal government decide which states need it most? NPR pharmaceutical correspondent Sydney Lupkin looked into that question and joins me now. Hey, Sydney.


FADEL: So, Sydney, first, remind us what remdesivir is and why the federal government is allocating it in the first place.

LUPKIN: Sure. Remdesivir is an experimental COVID-19 drug made by Gilead Sciences. It's an antiviral given to patients in the hospital. And it's one of only a few treatment options doctors have for these seriously ill patients. The federal government secured nearly all of Gilead's supply from July through September and has been sending weekly allocations around the country based on a series of data points, like how many patients in a state are hospitalized with the virus. But remdesivir is in short supply, so that's why fair allocation is so important.

FADEL: So what did you set out to find in your reporting?

LUPKIN: Well, I wanted to take a look at the federal data and see for myself how the allocation was going. Was it fair? What I discovered was that there are a lot of missing pieces of that data that are simply not public. Here's infectious disease physician Michael Ison of Northwestern University.

MICHAEL ISON: I don't know that we can say they're doing a good job. I don't know that we have the data.

FADEL: OK. So it sounds like there are missing pieces. Did you learn anything from the data that was available?

LUPKIN: Yes. We saw that every week, HHS was allocating less remdesivir to some states than the week before even as COVID-19 hospitalizations in those states were trending upward. Meanwhile, we learned that sometimes HHS allocated enough of the drug to a state to treat everyone in the hospital with this virus more than once, while others were offered enough to treat less than 10% or none at all.

Overall, we found that hospitals really can't predict how much remdesivir they're going to get from one week to another, making it really hard to plan ahead. Do you treat all your eligible COVID-19 patients with remdesivir, or do you just save some in case HHS decides you don't get any the next week?

FADEL: Wow. So go into some specifics for us. What's an example of a state that's not getting enough?

LUPKIN: So in early July, North Carolina's coronavirus cases were climbing fast. Over the prior two weeks, only five states had more new COVID-19 cases than North Carolina did. And on July 9, the governor announced that it was seeing its highest number of hospitalizations yet. Meanwhile, HHS is allocating remdesivir to 31 states, but not North Carolina. Here's infectious diseases physician Cameron Wolfe at Duke University Medical Center.

CAMERON WOLFE: To suddenly be told, OK, you're not getting any this time and yet when you have patients going up, it certainly gave us pause, to be diplomatic.

LUPKIN: The state health department tells me this was a shock. It still doesn't know why it wasn't allocated any that week but fortunately got an allocation the following week.

FADEL: Well, that's good. But we have a really long way to go in this pandemic. What's going to happen moving forward?

LUPKIN: Overall, I'm told HHS seems to be getting better at allocating the drug. For instance, it says it's now weighing new hospital admissions more heavily, which makes sense. But when I asked HHS why it doesn't make all the data involved in remdesivir allocation public, it said state health departments can access it. But that still leaves a lot of people out of the loop. One thing is for sure - we might face the same issues with vaccine allocation.

FADEL: That's NPR pharmaceuticals correspondent Sydney Lupkin. Thanks, Sydney.

LUPKIN: Thanks for having me.

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