MSF responds to latest WHO recommendation for COVID-19 medicine baricitinib

Yemen \\ MSF response to COVID19 second wave in Sana'a

Yemen 2021 © Hareth Mohammed/MSF

Governments must stop Eli Lilly from blocking the generic production of this lifesaving, easy-to-administer medicine in countries hit hard by COVID-19

NEW YORK/GENEVA, JANUARY 14, 2022—As the World Health Organization (WHO) recommended today baricitinib for the treatment of people with severe or critical COVID-19, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) calls on governments to take immediate steps to ensure that patent monopolies do not stand in the way of access to this treatment. While this oral, easy-to-administer treatment could be critical for people hospitalized with COVID-19, US pharmaceutical corporation Eli Lilly has filed and obtained patents widely, including in countries hit hard by the pandemic, such as Brazil, Russia, South Africa, and Indonesia—blocking the production of affordable versions of this medicine.

In hospitalized COVID-19 patients, the oral drug baricitinib can be a potential alternative to current WHO-recommended anti-interleukin-6 inhibitors monoclonal antibody treatments tocilizumab and sarilumab, which remain in short supply for governments and patients in many low- and middle-income countries like those in which MSF operates.

Despite the fact that baricitinib is already approved for other conditions like rheumatoid arthritis—and generic versions are already available in India and Bangladesh at much lower prices than those being charged by Eli Lilly—baricitinib will not be widely available to treat COVID-19 as long as the company continues to block the generic production in most places. An Indian manufacturer priced baricitinib at $5.50 per treatment course of 4mg once per day for 14 days, and the lowest listed price in Bangladesh is $6.70. This is nearly 400 times less than Eli Lilly’s exorbitant listed price in July of $2,326 per treatment course.

Baricitinib is another example of why the World Trade Organization TRIPS waiver is urgently needed. The TRIPS waiver would waive patents and other intellectual property (IP) rights on urgently needed COVID-19 vaccines, treatments, tests, and other health tools for the duration of the pandemic. With the COVID-19 pandemic showing no signs of abating, it is clear that this waiver on IP rights is essential.

Dr. Márcio da Fonseca, infectious diseases medical advisor with MSF’s Access Campaign, said of the recommendation:

“For nearly two years, we have helplessly witnessed people dying of COVID-19 amid catastrophic waves of the disease. In countries where MSF works, the possibilities for providing high-level intensive care are limited, so saving more lives of people with severe and critical infections relies heavily on having access to affordable medicines that we can add to the steroids, oxygen, and close supportive care that we already provide in our projects.

“As new treatments emerge, it will be simply inhumane if they remain unavailable in resource-limited settings just because they are patented and too expensive. Since the start of this pandemic, financially strapped countries have been struggling with inequitable access to all lifesaving COVID-19 medical tools such as oxygen, vaccines, and tests because of hoarding by rich countries and pandemic profiteering by pharmaceutical corporations.

“With these proven therapeutics like baricitinib recommended by the WHO, it's time now for low- and middle-income countries to finally access these therapies that are already in routine use in many high-income countries. Governments must step up and take immediate action—including calling for the adoption of the TRIPS waiver and the use of public health safeguards such as compulsory licensing to override patent monopolies—in order to ensure equitable, uninterrupted, sufficient, timely, and affordable generic production and supply globally. 

“As many low- and middle-income countries continue to live in fear of more catastrophic COVID-19 waves in light of low vaccination coverage and the emergence of newer variants that may threaten efficacy of existing preventive tools, equitable access to therapeutics such as baricitinib will be key for treatment providers to save as many lives as possible.”