Pfizer cut the price of Paxlovid, but China wouldn’t take it: Industry insider


Chinese negotiators tried to get Pfizer to cut the price of its antiviral Paxlovid — a first-line treatment in the ongoing wave of COVID-19 infections sweeping the country — to just 200 yuan a box, an industry insider told Radio Free Asia .

Negotiations between China’s National Healthcare Security Administration (NHSA) and Pfizer “failed due to the high price of the drug,” according to the Chinese state-backed media outlet. reported last week.

The nationalist tabloid Worldwide times accused the US “capital forces” of profiting from the current wave of COVID-19 amid a continued shortage of antivirals and widespread reports of pneumonia since restrictions were lifted last month.

The financial magazine Caixin quoted unnamed sources as saying Pfizer had not significantly lowered its price above the 1,890 yuan (US$280) currently charged to Chinese hospitals, while the Global Times said the drug was not included in the national health insurance program from China because of the high price.

That claim was judged “misleading” following an investigation by the Asia Fact Check Lab, which is affiliated with Radio Free Asia.

Zhang Ning, a healthcare insider, said Chinese negotiators had already persuaded Pfizer to lower the price of a box of Paxlovid from its original price of 1,890 yuan to just 604 yuan.

“[But] the price they wanted to get it on the medical insurance [approved list] was 200 yuan per box,” said Zhang. “[Homegrown antiviral] Azvudine was included in the health insurance catalog for 270 yuan/box.”

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She said Azvudine, a broad-spectrum antiviral drug developed in China to treat HIV/AIDS and approved for use in the national health insurance system last August, costs much less to produce than small molecule treatments like Paxlovid.

While Radio Free Asia was unable to independently verify Zhang’s claims, they are similar to recent comments by Albert Bourla, CEO of Pfizer, who recently said negotiations fell through because the Chinese side wanted to sell Paxlovid at a price lower than the price from Pfizer for low and low prices. middle-income countries.

Lower than El Salvador

Bourla said on Jan. 10 that talks with China about future prices for the treatment broke down after China asked for a price lower than Pfizer charges for most low-middle-income countries.

“They are the second largest economy in the world and I don’t think they should pay less than El Salvador,” Bourla said in comments reported by Reuters at the time.

Zhang said it was unclear why the health insurance agency had pushed for such a low price for Paxlovid, given that Azvudine is still in clinical trials.

“The cost of the technology to produce small molecule drugs [like Paxlovid] is very high … and the phase three clinical trials for Azvudine have not even been completed yet,” she said. “They just recruited 1,000 COVID-19 patients into the trial.”

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Li Sha, chief pharmacist at Xi’an Jiaotong University’s No. 2 Affiliate Hospital, said Azvudine was primarily indicated for use in patients over 60 with underlying health conditions.

“[This is] because there have been many side effects, including damage to the nervous system and liver and kidney function,” said Li.

“It is not recommended for pregnant and lactating women, as well as patients with severe liver and kidney damage.”

Zhang said the dispute comes amid a nationwide shortage of Paxlovid, which is known to be changing hands for tens of thousands of yuan a box on the black market.

“There isn’t [Paxlovid] not available at all, and even on the black market there has been no sign of new stock in recent days,” she said. “So many people are waiting to buy them.”

“Everyone is currently buying oxygen machines on the black market and buying them together with human serum albumin,” Zhang said.

Black market

A Shanghai resident who gave only the last name Huang said that human serum albumin is currently sold in hospitals for several hundred yuan/dose, and for anything between 1,500 and 5,000 yuan on the black market.

According to Zhang, the albumin can only be obtained from human plasma and the current shortage reflects a general shortage of blood donors.

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A recent study by the Asia Fact Check Lab suggested that the price of Paxlovid had little to do with the decision not to include it in the medical insurance list of approved drugs.

Paxlovid, also known as Naimatevir Tablets/Ritonavir Tablets, is an oral small molecule antiviral drug that is “highly recommended” by the World Health Organization for the early and mid-term treatment of people at risk of serious illness following infection with COVID – 19.

The US government has already agreed to purchase 10 million courses of the drug at a cost of about US$530, or 3,700 yuan, compared to the price of 1,890 yuan per box initially agreed for the Chinese market.

Germany has agreed to purchase one million boxes at a cost of 500 euros, or 3,640 yuan per box, the study found.

It found that Beijing had allocated enough funds to pay Paxlovid, with the national health insurance fund currently enjoying a surplus of more than five trillion yuan, with sales up 7.7% from January to November 2022, compared to the same period the year before.

It cited an economist who said Paxlovid wouldn’t make enough money for China’s healthcare system.

“It was never about spending tax money, nor whether [Paxlovid] is worth the money,” said the economist. “The real question is who makes money.”

Translated by Luisetta Mudie.