Sydney Lupkin

By the second week in July, COVID-19 cases in North Carolina were climbing fast.

With nearly 19,000 diagnoses over the previous two weeks, only five states recorded more new coronavirus cases than North Carolina did.

"Today is our highest day of hospitalizations and our second-highest day of cases," Gov. Roy Cooper, a Democrat, announced on July 9, standing behind a podium in the state's Emergency Operations Center. "Please continue to treat the virus like the deadly threat that it is."

How much will vaccines against the coronavirus cost? Even though none has finished clinical testing, some clues about pricing are starting to emerge.

Cambridge, Mass.-based Moderna, one of the leading horses in the vaccine race, has already made deals at between $32 and $37 per dose of its experimental coronavirus vaccine in agreements with some foreign countries, rattling consumer advocates, who fear an unfair deal for U.S. taxpayers.

The federal government has reached a deal worth up to $2.1 billion with drugmakers Sanofi and GlaxoSmithKline as part of Operation Warp Speed, the Trump administration's push to have a coronavirus vaccine widely available by early 2021.

The money will go toward clinical trials, scaling up manufacturing and purchasing 100 million doses of the vaccine.

The Trump administration has announced four executive orders to lower drug prices, but health policy experts say they will likely offer patients only minimal relief and may take months to implement, if they're implemented at all.

The orders signed Friday afternoon included allowing certain drugs to be imported from Canada and making changes to the way discounts negotiated by middlemen called pharmacy benefit managers are passed on to Medicare patients.

The federal government has reached a $1.95 billion deal with Pfizer to acquire 100 million doses of its vaccine candidate against the coronavirus if the Food and Drug Administration OKs it. The vaccine would be free to Americans, according to the deal, though health care providers could charge to administer it.

When the order of 100,000 masks arrived at an unnamed factory for use in protecting workers against COVID-19, they were covered in dirt, dust and mysterious stains. In short, they were "not fit to be used," according to a complaint filed with the Food and Drug Administration in late March.

The drugmaker behind the experimental COVID-19 treatment remdesivir has announced how much it will charge for the drug, after months of speculation as the company tried to figure out how to balance profit and public health needs in the middle of a pandemic.

More than 100 coronavirus vaccines are being studied around the world, but less than a dozen have begun testing in humans.

The federal government's goal is to have a COVID-19 vaccine ready by January 2021. To achieve that objective, the White House formed Operation Warp Speed, a public-private partnership, to push the development, testing and manufacture of a vaccine at a breakneck pace.

States are beginning to receive cases of an experimental COVID-19 drug that the Food and Drug Administration authorized for emergency use on May 1.

But the distribution process so far has puzzled some hospitals and states about why they've been left empty-handed.

Now that the Food and Drug Administration has authorized remdesivir for emergency use in seriously ill COVID-19 patients, the experimental drug is another step closer to full approval. That's when most drugs get price tags.

Gilead Sciences, which makes remdesivir, is donating its initial supply of 1.5 million doses, but the company has signaled it will need to start charging for the drug to make production sustainable. It's unclear when that decision might be made.

Gilead Sciences, the drugmaker behind the experimental COVID-19 treatment remdesivir, spent more on lobbying Congress and the administration in the first quarter of 2020 than it ever has before, according to federal filings.

The pharmaceutical company spent $2.45 million on lobbying in the first three months of the year, a 32% increase over the $1.86 million it spent in the first quarter of 2019.

The coronavirus pandemic has renewed concerns about the dependence of the United States on other countries for supplies of prescription drugs and ingredients.

The U.S. ignored the decline of domestic medical manufacturing and waited too long to seriously invest in the federal office designed to prepare for pandemics, Sen. Chris Coons, D-Del., said in an interview.

"We are now paying both in needless exposure by our front-line health workers and needless deaths for having not been better prepared for this," he says.

Rene Roach fired off a quick email in late March for an update on a colorectal cancer clinical trial for which she hoped to qualify.

Worried about the coronavirus, she asked, almost as an afterthought, whether the study had been put on hold because of the pandemic.The answer crushed her: It had been.

"That's when COVID-19 shut down everything," says Roach, 50, of Germantown, Md.