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The biggest problem with remdesivir is that it is administered intravenously. That makes it very hard to administer unless the patient is in the hospital. What would be ideal is if they had it in pill form, and then anyone with early symptoms could get pills instead. But without that option right now it makes it too late to administer unless the patient is already in severe condition.

They are planning on testing an inhalant version but who knows where that will land in terms of effectiveness. It might make things worse so that is much further out unless things are really lucky, which we haven’t had a lot of with coronavirus.

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Take a look at EIDD-2801, it's essentially a pill form of remdesivir.

https://www.thepharmaletter.com/article/ridgeback-bio-triall...

Home infusion medicine is a fairly big, and growing, option in the States. A drug being IV is definitely inconvenient, but there are some options.

Curious, how does that work?

Your physician prescribes an IV medication, and refers you to either a hospital, clinic, or a home infusion provider depending on a variety of circumstances. If you end up with a home IV provider, they process your prescription, ship the drug to your house in a refrigerated container, and schedule a nurse to come out and infuse you. The nurse brings and leaves any supplies you might need.

Interesting. Curious to know any FDA approvals for the process or the infusion of this drug? I am curious how the act of processing the prescription and refrigeration can be done safely without compromising the drug itself

Honestly that's starting to get past the parts of that industry I'm really familiar with. I'd have to Google it same as you.

Here's the FAQ page for one of the biggest USA home IV companies. It's a good starting point if you're curious.

https://www.coramhc.com/patients/faqs

Storage and handling is approved when the drug is approved.

Basically you tell the FDA how to store and handle and the FDA says “ok, give me the data that proves the drug is stable under those conditions”.

Beyond that the FDA doesn’t really care who administers it.

My nephew receives Remicade infusions to treat Crohn's Disease. He typically receives the treatment at a local, children's hospital; however, due to Covid-19, my sister elected to have an in-home infusion performed. Appears to be a fairly efficient process.

Interestingly, their insurance company has been trying to push them into performing his infusions at home for a couple years, as it is more cost effective. My sister has to fight them on it every couple of months to continue having them performed at the hospital.

Is there a particular reason she insists on having it done at the hospital? Higher standard of care or just being there should anything go awry?

Genuinely curious.

Honestly, my sister is a very anxious person, and my nephew had a lot of complications with Crohn's prior to starting infusions. I think it is more precautionary on her part than anything.

Before the first infusion, she was advised by hospital staff that the insurance company might refuse coverage for infusions onsite if the procedure was ever performed in-home.

Imagine if all high school students got trained on how to start an IV.

Every heroin junkie gives themselves IV injections. It's not hard.

To get their shot. Also, they screw up their veins (see Requiem for a Dream).

I myself have fear of needles, so I'm biased in this sense. I would not use this drug, except with a Oxazepam. Which I prefer not to, as these too are addictive.

You're right but an injection is not an infusion.

An infusion is something that takes a longer time as the drug is taken slowly into the bloodstream (might be something that takes a couple of hours).

> What would be ideal is if they had it in pill form, and then anyone with early symptoms could get pills instead.

This doesn't seem wise; the side effects of remdesivir seem worse than the typical course of a cold/flu.

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