Price of lifesaving Covid-19 antiviral Paxlovid expected to rise next year, raising concerns about access

CNN
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As the U.S. continues to move out of the emergency phase of the pandemic, the price of the lifesaving COVID-19 drug Paxlobid will likely rise next year for most patients, doctors say. There are growing concerns that the drug may become difficult to obtain.

Like this season’s coronavirus vaccines, the antiviral drug combination nilmatrevir and ritonavir will also go from being freely available to everyone through government purchases by the end of this year to more traditional options available to most patients. The company plans to move into the commercial market.to the usa Ministry of Health and Human Services and pharmaceutical companies pfizer.

The new price (before insurance) has not yet been set, but is expected to be higher than the $530 per course price paid by the U.S. government.

According to HHS, people on Medicare, Medicaid, or those without insurance will continue to be able to get Paxlobid for free through patient assistance programs through 2024, but those with commercial insurance will have to pay out-of-pocket. is likely to occur, said Albert Bourla, CEO of Pfizer. Monday. About 40% of Paxrovid prescriptions are written for Medicare and Medicaid patients, the company said.

“We are beginning negotiations with payers,” Bourla said. Said Analysts and investors participate in an internal conference call. He said the “pandemic price” the US pays is likely to be “lower” than the new commercial price.

Evercore ISI’s Umar Rafat, one of the financial analysts who follows the company, suggested the price could rise three to five times, to $2,500 per course.

Dr. Eric Topol, a professor of molecular medicine at Scripps Research, called the potential price increase plan “just more bad news for price gouging by Pfizer.”

“Fewer people who need paxlobid will be able to receive it, whether due to lack of insurance or concerns about payment and co-pays,” Topol wrote in an email. “Forcing it on insurance companies, even for people with full coverage, will only increase health care premiums for everyone in the long run.”

Infectious disease doctors shared Topol’s concerns about people’s access to the drug.

“There is no question that cost is a major factor determining access to medicines in the United States,” said Dr. Paul Sachs, clinical director of the Infectious Disease Clinic at Brigham and Women’s Hospital and a professor at Harvard Medical School. Stated. He pointed out that insurance plans vary widely in coverage and out-of-pocket costs.

“The higher these costs are, the more likely people are to forgo treatment,” he said.

A Pfizer spokesperson said the company will share pricing information “in the coming weeks,” adding, “Paxlovid is eligible for inclusion due to its important role in reducing COVID-19 infections. “We have and will continue to deliver value to patients, healthcare professionals and healthcare systems.” There were 19 related hospitalizations and deaths among people at high risk of severe illness. ”

Since the medicine came out, It is shown to reduce Children’s Hospital Infectious Diseases Division says vulnerable groups are at risk of severe illness and death from COVID-19, and access is critical even as the virus moves away from the forefront of everyday life. said Dr. Paul Offit, professor of pediatrics. Philadelphia.

“This virus is not over,” he said, noting it could continue to circulate for decades to come. “People at highest risk of severe illness should test themselves to see if they have an upper respiratory tract infection, and if they test positive very early in the course of the disease, , they need to take Paxlobid. Save their lives.”

paxrovid is Available Depending on the prescription, it must be taken within the first 5 days of symptoms.

After coronavirus-related hospitalizations peaked in early September, coronavirus infections appear to be slowing in the United States.Same as last year saw Waves increase in late summer and are usually followed by larger waves towards the end of the year. However, it is unclear what pattern this winter will have.

Other serious respiratory viruses are also becoming more prevalent. Levels of respiratory syncytial virus (RSV) appear to be low nationwide However, I picked it up with southEspecially in Florida. In the first week of October, flu levels remained low or minimal in all states except Alaska, where levels were moderate, according to the report. data From the Centers for Disease Control and Prevention.

This season, protection against all three major respiratory viruses is available for the first time: influenza, COVID-19, and RSV, the CDC announced. It is recommended All subjects are protected from all three.

Two RSV vaccines were approved this year for adults over 60, and another was approved for use during pregnancy to protect babies in the early years of life. Protective antibody shot against respiratory syncytial virus approved for infants, CDC approved It is recommended It is available for all babies up to 8 months old and some older babies who are more susceptible to serious illnesses.

Newer Covid-19 vaccines designed to protect against recently circulating virus strains are also available, and the CDC recommends them as well as seasonal influenza vaccination for everyone 6 months of age and older. I am.

The price of coronavirus vaccines also rose after the U.S. government stopped universal distribution.Pfizer, Moderna and Novavax shots price was set During the pandemic, companies increased their purchases, with large government purchasing contracts paying between $15 and $30. price After the U.S. moved away from a system where the government paid for vaccinations, the cost of vaccinations nearly quadrupled, to $115 to $130 per dose.

The vaccine should still be covered by insurance, but for some people it is. Self-pay amount will be incurred It was improperly done in the early stages of the fall rollout as insurance coverage through the commercial market becomes established.

Doctors are concerned that paxlobid’s high price could cause problems.

“Making it more expensive just creates a bigger hurdle,” Offit said. “Do you think that will limit your intake? Yes, it will.”