| Early Wednesday, Eli Lilly announced a $375 million deal to supply the U.S. with its Covid antibody treatment. The Trump administration has aggressively corralled doses of coronavirus antivirals and experimental vaccines—even malaria drugs that have since shown to be ineffective against the infection. But in this case, the U.S. can't snap up all of Lilly's supply. Initially, the deal will allow the U.S. to procure 300,000 vials of the antibody, if it's authorized. But Lilly's keeping additional vials at arm's length. The nation can purchase 650,000 more through June if it demonstrates "medical need," Lilly CEO David Ricks said in interviews this month.  David Ricks, chairman and CEO of Eli Lilly. Photographer: David Paul Morris/Bloomberg The broader monoclonal antibody class, which includes Regeneron Pharmaceuticals' therapy that President Trump received, has been called a "bridge to a vaccine." Ricks said he wants to ensure Lilly's version can go to countries that need it most, when they need it most. Not all drugmakers have been so focused on the fine print, with some eager to clinch agreements for top-tier prices. Ricks says Lilly will follow its own principles as it negotiates with governments. First, it would allocate supplies based on the disease burden of each country. With the U.S. currently seeing the bulk of cases, Ricks said, it would initially get the majority of doses. Second, Lilly would try to ensure that central governments would be in charge of allocating the drug and offer it to patients at no out-of-pocket cost. It's possible that medical providers will charge for intravenous administration of the medicine, Ricks said. Finally, the drugmaker would price the drug through a tiered system that takes into account countries' ability to pay. The U.S. deal implies a top-end price of about $1,250 per dose. That's about half the cost of Gilead Sciences' remdesivir, which has been shown in some studies to benefit seriously ill Covid patients. Lilly's treatment hasn't been effective in studies of hospitalized coronavirus patients, and still has to undergo tests to confirm that it benefits the less severely ill. And while the company's approach to allocating the treatment may come under fire, as Ricks cautions, for now it looks like a step in the right direction.—Riley Ray Griffin | 
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