Recently, the National Medical Insurance Administration of China revealed that the negotiation with Pfizer on the entry of Paxlovid (Pfizer Naimatevir Tablets/Ritonavir Tablets Combination Package) into the Chinese Medical Insurance Catalog failed.
This means that in the future, patients with the new crown in China will have no hope of obtaining this special drug at a low price. At this time, there was a major outbreak of the epidemic in China. As soon as the news came out, it immediately sparked heated discussions on the Internet. Some public opinion pointed out that the country’s new crown “dynamic zeroing” policy in the past three years has brought about a huge financial deficit, which has stretched the inclusive medical insurance; there are also official background voices criticizing Pfizer, which is against business ethics.
On January 8, the 2022 China National Medical Insurance Drug List negotiation ended. The National Medical Insurance Administration of China stated that the negotiation failed because the manufacturer Pfizer Investment Co., Ltd. had a high offer for Paxlovid.
The medical insurance bureau also stated that although Paxlovid failed to be included in the medical insurance catalog through negotiation, according to the recent documents jointly issued by the National Medical Insurance Bureau and some departments, including the “New Coronavirus Infection Diagnosis and Treatment Program (Trial Version 10)” and other guidelines, Paxlovid and For all other new crown treatment drugs, medical insurance will temporarily pay until March 31, 2023.
In addition, Huang Xinyu, deputy director of the Medical Service Management Department of the Bureau, also stated last Thursday (January 12) that there are more than 600 symptomatic drugs in the medical insurance catalog for the treatment of colds, fevers, and coughs (common symptoms of patients diagnosed with new crowns). There are many clinical options for the insured to use drugs.
As soon as the news came out, there was an uproar on Chinese social media. Some people pointed out why China had the funds to conduct countless nucleic acid tests when it made great efforts to implement the “zero-out” policy in the past.
Netizen “JAK_R” said: “The money in the medical insurance has been squandered by doing nucleic acid. Now I really need to buy life-saving medicine. Well, I have no money.”
In the three years since the epidemic, China has spent huge amounts of money on epidemic prevention. According to the Chinese media Caixin, in the past three years of the epidemic, Guangdong province alone has invested a total of 146.793 billion yuan (21.68 billion U.S. dollars) in epidemic prevention and control. In the past three years, Guangdong’s financial investment in epidemic prevention and control is equivalent to 2.34%, 3.22% and 5.36% of the general public budget of the year, increasing year by year.
The Guangdong Provincial Department of Finance disclosed that the 2020 epidemic funds will be used for nucleic acid screening, fever clinic screening, patient treatment, and caring for frontline staff of epidemic prevention and control.
Hu Xijin, the former editor-in-chief of the official media Global Times, criticized Pfizer on Weibo for violating the morals that pharmaceutical companies should have.
“Pfizer still wants to make money too much, and wants to make a fortune in China with a large population, so it refuses to lower the price, which leads to the failure of the negotiation with the Chinese government on Paxlovid’s entry into medical insurance. It is normal for pharmaceutical companies to want to make profits, but Pfizer is now a bit ‘It’s hard to get rich’ mentality, it’s not good,” he wrote.
Citing Pfizer CEO Albert Bourla, Reuters reported that China is asking Pfizer to offer lower prices than it offers to low- and middle-income countries.
“They’re the second largest economy in the world, and I don’t think they should pay less than El Salvador,” Aberle said. El Salvador is a small, poor country in Central America.
Aberle also said that it has reached an agreement with local partners in China to produce Paxlovid locally and sell it in the Chinese market.
Currently, the price of Paxlovid in China is RMB 1,890 per course of treatment. Chinese media have mixed reports on Pfizer’s medical insurance offer. According to Tencent Prism, Pfizer’s actual quotation is more than 600 yuan, but it is still far from the bottom line of the National Medical Insurance Bureau. Caixin reported that, in fact, Pfizer’s quotation basically did not drop from the level of 1,890 yuan.
Chen Xi, an associate professor of global health policy and economics at Yale University, told BBC Chinese that the contract price signed by the US government and Pfizer is US$530 for a course of treatment. Pfizer’s pricing for each country is linked to its economic development and per capita income, and the suggested price for China is therefore cheaper than that of developed countries.
He believes that, as the government’s procurement of key materials for the public health crisis in the context of a pandemic, it is different from the attributes of the centralized procurement of medicines in general periods, and the urgency of reducing severe illness and death should be considered; China’s pricing is indeed a severe test of the affordability of China’s medical insurance budget, especially after three years of strong “clearing” medical and health funds are overdrawn, and the income of medical insurance will also shrink in the economic downturn.
“In response to these concerns, medical insurance can consider introducing but reducing the reimbursement ratio, especially appropriately reducing the reimbursement ratio for groups with more financial means, taking into account fairness,” Chen Xi suggested.
“Life-saving drug” Paxlovid
In the current round of the epidemic in China, the number of deaths due to the new crown continues to increase.
Recently, the Joint Prevention and Control Mechanism of the State Council of China held a press conference and announced that from December 8, 2022 to January 12, 2023, a total of 59,938 deaths related to the new coronavirus infection occurred in medical institutions across the country, among which the infection caused respiratory failure. There were 5,503 deaths, and 54,435 deaths from underlying diseases combined with new coronavirus infection.
Paxlovid is one of the most effective drugs for the treatment of new crowns, especially for critically ill patients.
In April 2022, the World Health Organization issued a statement stating that Nematervir and Ritonavir (trade name Paxlovid) are strongly recommended for patients with the highest risk of being hospitalized for COVID-19. Paxlovid is by far the best treatment for high-risk patients choose.
The statement stated that it is strongly recommended to use the combination of Naimatevir and Ritonavir tablets for the following new crown patients: non-severe illness, but the highest risk of developing severe illness and requiring hospitalization (such as unvaccinated, elderly or immunocompromised) By).
According to the World Health Organization, data show that the risk of hospitalization can be reduced by 85% after receiving this treatment. In high-risk groups (more than 10% risk of hospitalization), this means that the number of hospitalizations can be reduced by 84 per 1000 patients.
“Paxlovid is one of the few drugs that has passed double-blind trials and real-world testing, and can really reduce the risk of severe disease against the new crown. Among antiviral drugs, it is currently the best in terms of effectiveness and safety, and it should be used under the guidance of a doctor. It is also the most convenient,” Chen Xi pointed out.
He said that Paxlovid has a clear clinical effect on the treatment of the new crown, and the demand is significant, but the supply is extremely tight. As an important member of the COVID-19 treatment toolbox, China should prepare sufficient quantities and arrange fair and effective distribution channels before deciding to release the virus, so as to minimize the crowding, pressure, and death toll of intensive care units.
“I hope that Paxlovid will be negotiated into the medical insurance, not only to make the people as affordable as possible, but also to ensure the supply of this drug after entering the medical insurance, and to meet the conditions after infection – people with high risk of severe illness can use it in time. Reduce private Improper hoarding and price hikes in the market,” Chen Xi said.
At present, the Spring Festival travel in China has begun, and many people worry that the large-scale movement of people will further spread and aggravate the epidemic.
Due to the severity of the epidemic, there is a great demand for Paxlovid. This drug is also called a “life-saving drug” by many people. Even Chinese people who are not infected want to stock up for peace of mind. The drug is sold at a high price on the black market. According to Chinese media reports, a box has been sold for tens of thousands of yuan.
Wu Muluan, an associate professor at the Lee Kuan Yew School of Public Policy at the National University of Singapore, told BBC Chinese that in the past, the Chinese government insisted on the policy of “zeroing out” the new crown, so there was no such urgency to prepare for treatment drugs.
According to public reports, in February 2022, the China Food and Drug Administration approved the import registration of the combination package of Neimatevir/ritonavir tablets (ie Paxlovid).
Wu Muluan pointed out that at present, the domestic demand for Pfizer drugs is strong, and many people even buy them through the underground market. The ideal situation is that Paxlovid will enter the medical insurance, so that more poor and marginalized people in China can afford it, so as to greatly reduce the rate of severe illness and death.
He said that the current shortage of various medicines is due to the serious lack of preparation of the Chinese government for the epidemic, and the Spring Festival travel has begun, and the relevant Chinese departments have not introduced effective measures to protect the elderly.