Can remdesivir live up to the hype?

The latest round of hype on Covid-19 drugs began when Stat News reported on a leaked video discussion about Gilead Sciences Inc’s remdesivir. A Chicago doctor who had tested it on severely ill patients suggested it was working — that most of those who were given the medicine recovered and were discharged. The market is reacting as if the drug were already a commercial hit: Gilead shares have been up 12% in early trading.
Investors should be clear about what this report is and isn’t, however. It is a promising anecdote that suggests the drug might be useful. It is also extremely limited information from a small portion of a trial taken out of context. In other words, it’s miles from providing proof that remdesivir cures Covid-19. The story is even further from being a reasonable basis for a multibillion-dollar stock move.

Cart Before Horse
Anecdotal data gets people excited, especially when it sends a message they want to hear.
But it’s not especially good at predicting whether a drug will work. Just a few weeks ago, similar anecdotal reports suggested that hydroxychloroquine, an older malaria drug, could be a Covid-19 miracle medicine. More robust trials show side effects and limited efficacy.
Before this video emerged, the data on remdesivir was mixed. A New England Journal of Medicine report on compassionate use of the medicine also suggested promise, but it was likewise anecdotal. On the other hand, Chinese researchers running extensive controlled studies on it recently stopped them. A slowing outbreak hurt enrollment. However, RW Baird & Co analyst Brian Skorney argues that if the drug looked as effective as the Stat report suggests, those researchers would “certainly” have reported data.
The Stat report has sparked particular exuberance because it highlights significant effects in very sick patients — evoking images of people being brought back from death’s door. But in selecting severely ill patients, this trial screened out those requiring mechanical ventilation and those with multi-organ failure or kidney or liver impairment, according to Skorney.
That leaves a group of patients who probably had a better chance of recovery from the start, with or without remdesivir.
The Chicago hospital is just one site in a larger Gilead-sponsored study that lacks a control arm. Even when all the data are in, it will be difficult to know how well these patients might have done with supportive care or other therapies.
—Bloomberg

Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider