Aug, 2020 - By CMI
Key milestones of COVID-19 Pandemic
About the pandemic
Pandemics of infectious diseases have always created a havoc globally. While pharma giants have been busy researching treatments for cancer, rare diseases and neurological disease by large, every consultant across the world is wondering, whether the treatment for infectious disease been eliminated from their priority list?
Amid the outbreak of Nipah virus, swine flu, ebola and now corona virus, the question to ponder is that Why the global pharmaceutical fraternity, including the World Health organization (WHO), is not prioritizing the discovery of prevention/treatment solutions for such outbreaks.
Novel coronavirus, also referred as COVID-19 (Coronavirus detected in 2019), was first detected in Wuhan, China on 31st December 2019. Since then, in a span of 70 days, it affected more than 100,000 people globally. According to the WHO data, there were 9,800 cases identified in January 2020, which spiked to 85,600 cases by the end of February 2020. A staggering 770% increase.
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Coronaviruses are zoonotic, meaning they are transmitted between animals and people. A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.
A total number of 413,467 cases were reported by WHO as of 25th March 2020. Major affected regions/countries/territories include China (81,848 cases), Italy (69,176 cases), Iran (24,811 cases), Republic of Korea (9,137 cases), Spain (39,673 cases), Germany (31,554 cases), and France (22,025 cases) – as of 25th March 2020. China accounts for more than 50% of the cases globally. This has reduced significantly in recent days owing to high prevention and control measures taken by the Chinese government. Coherent Market Insights estimates the corona infected population to reach 1,950,000 by April 2020. Globally 26,654 deaths were reported by WHO as of 25th March 2020. Of which, 6,820 deaths (25%) were reported from Italy.
Every day, a new country/territory/region reports a case of COVID-19. According to the statistics, all first cases identified in countries other than China are imported cases only. A delay in diagnosis, leads to the massive spread of the infection.
Impact on economy
The fear of COVID-19 is clearly visible on the stock markets globally. A daily breakdown of 4%-7% has led the stock markets break all its long term support levels and reach a new low. This definitely is an opportunity for long term investors to buy stocks at a very lower price. However, it is necessary to understand the impact on the global economy at a much broader level.
At the same time, there are some unaffected/positively affected sectors as well:
Diagnostics
On March 13, 2020, the U.S. FDA provided an emergency clearance for two diagnostic tests – one from Roche and one from Thermo Fisher. The tests were approved within 24 hrs. of receiving the application from respective companies. Roche diagnostic kit is intended to be used with its cobas 6800/8800 molecular testing systems. Roche has the capacity to manufacture 400,000 tests (units) a week. On the other hand, the diagnostic test from Thermo Fisher is intended to be sued with its Applied Biosystems 7500 Fast Dx Real-time PCR instrument. Thermo Fisher plans to produce 5 million tests in a month.
A laboratory-based COVID-19 test takes around 5 hours to deliver results. U.K.-based Mologic Ltd., in collaboration with Senegalese research foundation Institut Pasteur de Dakar, developed a handy testing kit that can test the COVID-19 in just 10 minutes. This test, expected to be ready for sale by June 2020, for less than a US$ 1, is a transformational product in this emergency.
Treatment approaches
Pharmaceutical companies have taken immediate action in terms of identifying and developing drugs for treating COVID-19. In addition, companies are also researching for vaccines against this novel coronavirus. More than 35 treatments (including drugs and vaccines) are in development for coronavirus. HIV drugs are experimented on a huge scale as a potential treatment option for COVID-19 virus. This is only expected to increase as global health agencies, governments, and drug companies collaborate to put a common efforts against the SARS-CoV-2/COVID-19 virus.
Serum Institute of India plans to introduce COVID-19 vaccine by 2022. It has already initiated pre-clinical trials of the vaccine candidate. GlaxoSmithKline, J&J, Moderna Inc., and Sanofi are also working on to develop a vaccine for this virus. In all, there are more than 12 companies working towards developing a vaccine or drugs for coronavirus treatment or prevention.
However, the immediate potential treatment options include Remdesivir (Gilead) and Actemra (Roche). Roche has donated US$ 2 mn worth of Actemra to China based on its usage recommendation from China’s National Health Commission. Cost of Actemra is US$ 491 for a supply of 4ml IV solution. Both these drugs are being studies in phase 2 and 3 trials for coronavirus.
The mortality rate in China has decreased to 3.9% (as on 15th March 2020) which was once around 5% at the peak of coronavirus infection in China.
Current drugs approved for treatment:
Potential drugs under research and development:
Market Potential
With the possible assumptions of Actemra to be available at a discounted price in such pandemic situations, we estimate the market potential for the approved treatment to be as below:
With estimated monthly revenue of almost US$ 100 mn, corona treatment would account for more than 40% of Actemra’s current revenue (US$ 2.4 bn).
A vaccine, on the other hand is estimated to have a potential market of more than US$ 10.0 bn in China itself (considering the cost of the vaccine to be US$ 10)
So the question now is, if infectious diseases pose such a huge potential, why the pharmaceutical industry does not still pursue to invest in R&D for such pandemics?
Initiatives and Funding
The World Health Organization (WHO) is providing regular updates, and guidelines about coronavirus to create awareness. Also, global health agencies, and governments are creating an emergency fund for combatting coronavirus.
The U.S. government, approved US$ 8.3 billion emergency fund to treat and prevent the spread of novel coronavirus, COVID-19. This fund will be utilized for R&D, procurement of vaccines, therapeutics, diagnostics, support the state and local health agencies in the U.S., and spreading awareness on international level.
On 13th March 2020, the WHO, UN Foundation and partners launched first-of-its-kind COVID-19 Solidarity Response Fund. Individuals, organizations and governments are welcomed to donate amount in this fund that would support the action from WHO’s COVID-19 Strategic Preparedness and Response Plan.
On 13th March 2020, the European Commission proposed to direct an amount of EUR 37 billion to fight against the Coronavirus crisis.
Iran, which is among the affected countries in this pandemic, has asked for a US$ 5 billion emergency fund from the International Monetary Fund (IMF) to fight novel coronavirus in its country. Iran has been economically impacted since a long time, amidst US government sanction on oil and gas exports. Also, with countries closing their borders, the economy is further impacted owing to no oil and gas export.
Fig. 1: Number of additional health measures by type, WHO, 10th March 2020
A number of initiatives are expected to arise in the coming days, as the situation only worsens in regions outside China.
The world has been inadequately equipped to tackle epidemics and pandemics. Investments in defense are rising, however preparation for fighting infectious diseases is inadequate. Real danger to the human race are these invisible organisms and not the visible lives. Human’s strengths have been tested a many times recently with epidemics/pandemics such as Swine Flu, SARS, Ebola, and Nipah virus. The positive sunshine, after the dark of the dawn is that, the world has united to fight against this pandemic and prevent further deaths.
In this unprecedented time, the COVID-19 pandemic is having an impact on the health of our loved ones, the businesses we rely upon, the health of the global economy, and the way we live our daily lives. As every business continue to navigate through these unique and evolving challenges, humanity is hopeful that together it will overcome it, by bringing a cure (drug and vaccines) in the form of the silver living to the surrounded dark clouds of uncertainty, and terror.
Data Sources: WHO, BBC, UN News, Bloomberg, Center for American Progress, Roche Annual Report, Press Releases, News Websites, Coherent Market Insights
Author –
Saurabh Shah,
Principle Consultant – Healthcare,
Coherent Market Insights
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