On December 13, the online COVID-19 Clinic of a Chinese internet hospital under 111, Inc., a domestic digital healthcare platform, began to pre-sell Paxlovid (nirmatrelvir tablets; ritonavir tablets), an oral antiviral drug for COVID-19, at a price of 2,980 yuan ($427)/box. However, shortly after the news was reported, the drug was quickly removed from online platforms.
According to Chinese media outlet Caixin, when users land on the website and type in ‘COVID-19’ into the chat box, users will be assigned a doctor on the platform. The doctor will then ask whether the user has been diagnosed as COVID-19 positive and whether they want to purchase Paxlovid. The online doctor will stress that the the pill should not be used for prevention, but only for the treatment of confirmed patients, and users should upload their nucleic acid test or antigen test results before receiving a prescription. After online payment, users can expect the pill to be delivered by express delivery.
Paxlovid is a specific type of COVID-19 drug which is used to treat adult patients with mild to moderate COVID virus infections and are of high risk to more severe diseases, such as chronic kidney disease, diabetes, cardiovascular disease, chronic lung disease as well as those are of advanced age. Patients need to take the pill within 5 days of symptoms.
Paxlovid can reduce the incidence of severe cases and shorten the recuperation time. At present, its online purchase is at one’s own expense and is not yet covered by state medical insurance. The price of each box is higher than the medical insurance purchase price of Paxlovid by medical institutions (2300 yuan). Previously, the drug was mainly used by inpatients. However, because the indications were mild to moderate patients with high risk factors of progression to severe cases, the number of hospitalized patients was not large, and the hospital did not have much stock for oral medicine for COVID-19.
Before online sales began, the overseas purchasing businesses of Paxlovid and its Indian generic drug brands, Primovir and Paxista, was booming. According to Caixin, one Primovir purchaser said that they had started purchasing for customers in mainland China, Hong Kong, Macao and Taiwan in April this year. After the optimization of pandemic prevention measures in China in November, orders surged, and more than 50,000 boxes were sold, accounting for about one-third of the total sales. The price of the Indian generic drugs ranges from 900 to 2000 yuan per box.
It is worth mentioning that, like Paxlovid, another China-made COVID-19 oral drug, Azvudine Tablets, had also been approved in the country and was reported on November 19th that it could be purchased on several online platforms such as Ele.me and Meituan. Purchasers of these tablets also had to upload a prescription before being allowed to pay. However, at noon on the same day, drug manufacturer Genuine Biotech responded to Chinese media, saying that the company had communicated with the pharmacy stores for the first time that the drug would be removed from online platforms soon.
According to Yicai, insiders of China Nepstar, a chain pharmacy, said that an urgent notice had been issued internally, which stated that China’s National Medical Products Administration had informed them that online and offline retail of Azvudine Tablets were not allowed. If any have been sold, the sales records should be reported to the local Municipal Bureau. Some clinical experts have advised that the “Azvudine Tablets is a prescription drug and is approved by emergency authorization. Its use should follow the treatment guidelines and is not suitable for self-use or online sales.”