Nationwide Rationing of Remdesivir Puts Doctors in the Middle of an Ethical Dilemma

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Currents News Staff

The federal government is announcing a plan for rationing remdesivir, the only drug so far that has shown some promise as a treatment for severe coronavirus patients.

A shortage of the drug is now putting hospitals in a tough position, and given limited supplies, the federal government has been doling it out.

But some hospitals have been getting less than they need, and others have been getting none.

“New York State is working with HHS, Health and Human Services, on the federal side, administering to 2,900 people at 15 hospitals,” state governor Andrew Cuomo said. 

The federal government has given New York enough for 2,900 patients, but there are about 7,262 coronavirus patients in New York hospitals.

That same situation is playing out around the country. 

A vial from the first shipment of remdesivir was received last week by Massachusetts General Hospital in Boston, where Dr. Rochelle Walensky is chief of infectious diseases.

“We know that the doses of this drug that we are going to get are not going to be enough to treat every patient that we have in the hospital now,” she explained. 

As a result, they’ve had to make decisions about who gets remdesivir and who doesn’t .

This was hard,” she said.

At Mass. General, they have about 200 patients with the virus, and they have enough  remdesivir for only 65 patients. More patients are being admitted every day, and doctors don’t know when they’ll get more of the drug.

Mass. General’s decision: a hospital committee – not the patient’s doctor – decides who gets it.

“This is not how we like to practice medicine,” Dr. Walensky explained, but she says it’s the most equitable way to do it.

“It’s nearly an impossible situation to be in medicine when you think that there’s something you could and should be doing for somebody, and you don’t have it to give, ” she explained. 

The federal government has never explained how they decided which hospitals would receive remdesivir, and how much. 

“This drug is promising and we want to get it to the American people and the areas that need it most,” White House Press Secretary Kayleigh McEnany said. 

May 9, the federal government said in addition to sending remdesivir to hospitals they’d also send it to some state health departments, and intend eventually to send it to all state health departments.

But they haven’t said how much they’ll send to each state, or their formula for determining those amounts.

Representative Lloyd Doggett runs the House Ways and Means Health Subcommittee, and has been following the remdesivir rollout.

“This administration doesn’t believe in transparency, but healthcare providers need to know about this,” he said. “It has been bungled from the very beginning.”

Now, doctors are trying to do their best to allocate this scarce resource.