Last fall, a Virginia Commonwealth University initiative called Medicines for All discovered a way to cut the cost of Merck’s COVID-19 therapy from $2,000 per kilogram to $200. Now Medicines for All is working to reduce the cost of producing Pfizer’s COVID pill.
In an unusual three-way partnership, VCU has partnered with pharmaceutical companies and a major charity – the Bill & Melinda Gates Foundation – to lower the cost of COVID medications and increase access to healthcare.
But the $40 million in funding VCU has received from the Gates Foundation is expected to run out at the end of this year, clouding the future of research.
On Friday, Senator Tim Kaine toured the facility and met with leaders from the university, local pharmaceutical company Phlow and other stakeholders, who called on the senator to continue funding their work, reduce the costs of medicines and prepare for the next pandemic.
Too often, Kaine said, politicians debate the source of high drug costs without investing in research and development that can reduce costs.
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“This model of cost-cutting innovation is going to be very compelling to my colleagues on the health committee, Democrats and Republicans alike,” Kaine said.
In May 2020, Phlow received a $354 million federal contract to build a national stockpile of essential drugs and to manufacture the building blocks for more than a dozen drugs used to treat COVID-19.
Phlow was co-founded by Eric Edwards, a Richmond entrepreneur and doctor, and VCU Professor Frank Gupton, who also runs Medicines for All.
The organizations are also partnering with AMPAC Fine Chemicals, a pharmaceutical manufacturer in Petersburg, and Civica Inc., a nonprofit organization focused on addressing chronic generic drug shortages. Civica is opening a $125 million facility, which Kaine also visited, in Petersburg near the AMPAC plant.
Medicines for All has devoted much of its energy since its inception in 2017 to developing cheaper drugs for HIV, malaria and tuberculosis.
When COVID hit, it pivoted, reimagining how the COVID drug remdesivir was constructed. Then he switched to Merck’s COVID pill, molnupiravir, which was made with an expensive molecule called uridine. But VCU researchers have determined that the drug can be made using a molecule that costs a third of the cost, cytidine.
What used to be a six-step process to synthesize molnupiravir has become a two-step process. In just three months, VCU exceeded its goal of reducing the price of the drug by 40%.
VCU hasn’t found a solution to lower the price of Pfizer’s COVID pill, Paxlovid, but it is making progress, Gupton said on Friday.
Under the agreement between VCU, the pharmaceutical companies and the Gates Foundation, VCU will publish its research, giving open access to other countries or companies to manufacture the drug. Pharmaceutical companies allow it, believing they cannot make money selling COVID drugs in Africa and Asia. And they can still produce their drugs at a lower cost and provide better access to drugs around the world.
“I think it’s pretty unheard of,” Gupton said of the threesome arrangement.
Yes, VCU sacrifices its intellectual property, but it does so for the greater good, and it gets paid along the way. Gupton said it was like working for a living instead of playing the lottery. VCU gets its funding from the Gates Foundation whether or not it hits a home run. In exchange for this security, he gives free access to his discoveries.
“If we’re going to move forward in reducing the cost of healthcare, we need to be able to bring these innovations to market so people can benefit from them,” Gupton said.
Reducing drug costs is perhaps the top issue before the Senate health committee, Kaine said. The work done at VCU shows that the issue of drug pricing goes beyond regulation. This includes investing in innovation.
Kaine recently co-sponsored a bill called the Affordable Insulin Now Act, which would cap the cost of insulin at $35 per patient. The federal government would act as a safety net, paying for what’s left. Medicines for All does not currently work on insulin.
The Gates Foundation doesn’t usually renew its grants, but Gupton remains hopeful. If the foundation ends its funding, there are other global health organizations that VCU can approach, a spokesperson for the institute said.
Medicines for All is located in rented space in Virginia Bio+Tech Park, along the northern edge of downtown. It is within walking distance of the growing campus of VCU Health and the Colosseum, a major redevelopment project for the city.
For too long, Virginia has lagged North Carolina in attracting business and technology, Gupton said. Investments by the federal government and the Gates Foundation could change that.
What would set Virginia apart is her ability not only to innovate new drugs but also to manufacture them. There are many research parks across the country, Gupton said, but no development parks.
“I don’t want to be where the others are,” he added. “I want to be where we can create our own brand and capability that no one else can catch up with.”
Edwards, the co-founder of Phlow, said the government had made a down payment on manufacturing drugs and building up a national stockpile of key medical ingredients. A potential end to the pandemic would be an easy excuse for the government to neglect making future investments in medicine, which Edwards urged Kaine not to let happen.
The Richmond-area drug development and manufacturing industry could become a new pillar of economic development for the region, similar to the level of spending brought by the state government, Kaine said.
“Now it will be a whole new pillar.”
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