Risk of being an also-ran in Covid-19 therapy drugs race

As the government looks to expand its armoury of coronavirus treatments, a new battleground has emerged in the supply of effective Covid-19 therapies.

Infectious disease experts are warning that coronavirus treatments will be essential for years to come. Picture: Darrian Traynor

Australia is in danger of being left behind in the race to secure supplies of coronavirus treatments, as a new international battleground emerges for effective drugs that reduce hospitalisation and provide the path out of lockdown.

As it becomes clear corona­virus treatments will be needed for years to come, countries such as Britain and the US have established task forces to spearhead the procurement of Covid therapies as an effective supplement for vaccination. The federal government last week announced the purchase of 7700 doses of the antibody treatment Sotrovimab, but infectious diseases experts warn Australia has already been exposed, with limited supplies of effective drugs and not enough on order.

“These treatments are enormously expensive, but very effective," University of Sydney pharmaceutical chemist Nial Wheate said. “They have a limited shelf life and we can’t afford to wait for the clinical trials to be concluded before we start acquiring them in bulk.”

Chief medical officer Paul Kelly said Sotrovimab was one among hundreds of treatments the federal government was considering in the fight against Covid-19.

Currently, Australian hospitals administer three approved treatments to Covid-19 patients – ­ Remdesivir, an antiviral, Dexamethasone, a corticosteroid, and Tocilizumab, a monoclonal antibody. But a combination of supply chain interruptions and manufacturing constraints have left Australia isolated, according to Professor Wheate.

“At the moment Remdesivir is not manufactured in Australia, while the Therapeutic Goods ­Administration has issued a warning on Tocilizumab supplies and all the major Dexamethasone manufacturers are based overseas,” he said.

As well as advocating greater domestic manufacturing capability, Professor Wheate said the federal government should be ensuring it is “front of queue” in the acquisition of drugs such as Sotrovimab and Regeneron.

“Historically antivirals have been a hit-and-miss enterprise ­because they haven’t been widely developed. Instead we’ve commonly relied on small molecule treatments. But the future is biological medicines, especially against Covid-19, which are much more specific in targeting coronavirus proteins,” he said.

While small molecule treatments focus on the inflammation caused by Covid-19, the Sotrovimab and Regeneron therapies are monoclonal antibodies, which pinpoint antigens and fight off ­infection.

Regeneron, manufactured by Swiss pharmaceutical giant Roche, came to international prominence last year when it was used to treat Donald Trump after he contracted Covid-19. It has since been approved by the US and Japan, with “emergency use” granted in the EU, India, Switzerland and Canada.

In Australia, the drug has been “conditionally recommended” by the National Covid-19 Clinical Evidence Taskforce.

The EU has also thrown its weight behind the development of Covid therapies, as it continues to order supplies of Sotrovimab and Remdesivir.

Sotrovimab, manufactured by British drug company Glaxo­SmithKline, has been approved for emergency use in Bahrain, ­Kuwait, Qatar and Singapore, with Canada requesting its first shipment at the end of July.

University of Sydney infectious diseases expert Robert Booy welcomed the purchase of Sotrovimab, but warned that Australia needed to “watch this space carefully so it doesn’t fall behind”.

“We need to keep our eyes constantly on the horizon. It’s good they’ve acted quickly on Sotrovimab, but we’ll need more than 7700 doses.”