Minimum costs to manufacture and prices for new treatments for COVID-19 - Updated
Posted on 23.05.2021

Abstract

Background

Repurposing existing drugs with known safety profiles remains an important strategy in the

global efforts to suppress the ongoing COVID-19 pandemic, although to-date, only

dexamethasone, a corticosteroid and tocilizumab/sarilumab, anti-IL6 receptor monoclonal

antibodies are found to reduce mortality in critical care settings. An effective drug for

treatment and prevention in the earlier stages of disease is yet to be found. Several new

candidates are now under clinical investigation including ivermectin and colchicine. If found

effective, they would need to be readily affordable and widely available for it to be useful

globally.

Methods

Costs of production for new and potential COVID-19 drugs (dexamethasone, ivermectin,

colchicine) were estimated using established methodology, using active pharmaceutical

ingredients (API) data extracted from global shipping records. The estimated costs were

compared against list prices from low, medium and high-income countries. List prices of

tocilizumab and sarilumab were also assessed. Annual API export volumes from India were

used to estimate the current availability of each drug.

Results

All three analysed drugs can be manufactured generically at very low cost: per-course costs

ranged between $2.58 for IV dexamethasone (or $0.19 orally) to $0.12 for ivermectin. When

compared against international list prices, we find large variations between different

countries. Overall, drug API availability was good, with colchicine being the most available

with sufficient API exported over a recent 12-month period sufficient for 59.8 million

treatment courses.

Conclusions

Analysed drugs are widely available and can be reasonably produced for less than $0.1 per

day in oral formulations.