CNN
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Prices for the Covid-19 drug Paxlovid will likely rise next year for most patients as the United States continues to move out of the emergency phase of the pandemic, raising concerns among doctors that the drug will become more difficult to reach.
Just like this season’s Covid-19 vaccine, the combination antiviral drug nirmatrelvir and ritonavir will move from being freely available to everyone through government purchases to the traditional commercial market for most patients by the end of the year, according to the US Department of Health and Human Services and drugmaker Pfizer.
The new price for pre-insurance costs has not been set but is expected to be higher than the $530 per course price charged by the US government.
According to HHS, people on Medicare or Medicaid or those who are uninsured can still get Paxlovid for free through 2024 through a patient assistance program, but those with commercial insurance may face with copays, Pfizer CEO Albert Bourla said Monday. About 40% of Paxlovid’s prescriptions are written for Medicare and Medicaid patients, he said.
We are starting negotiations with payers,” Bourla told analysts and investors on the company’s conference call. He said the pandemic price the US has to pay will likely be lower than the new trade price.
One financial analyst who follows the company, Evercore ISI’s Umer Raffat, thinks prices could triple to fivefold, to as much as $2,500 per course.
Dr. Eric Topol, a professor of molecular medicine at Scripps Research, called the potential price increase plans bad news about Pfizer’s price gouging.
Topol wrote in an email that fewer people who need Paxlovid will receive it whether it is due to lack of insurance or concerns about payment/co-pays. Even for those who are fully insured, sticking with insurance companies in the long run only increases health care premiums for everyone.
Infectious disease doctors shared Topol’s concerns about people’s ability to receive the drug.
Dr. Paul Sax, clinical director of the Infectious Diseases Clinic at Brigham and Womens Hospital and a professor of medicine at Harvard Medical School, said there is no doubt that cost is a major factor in determining drug access in the United States. He notes that insurance plans vary widely in coverage and how much people have to pay out of pocket.
The higher these costs, he says, the more likely people are to forgo treatment.
A Pfizer spokesperson said the company plans to share pricing information in the coming weeks and that Paxlovid has and will continue to provide value to patients, providers and healthcare systems. conditions due to its important role in helping mitigate outbreaks related to Covid-19. hospitalization and death in people at high risk of developing severe disease.
Dr. Paul Offit, a professor of pediatrics at the University of California, said because the drug has been shown to reduce the risk of severe illness and death from Covid-19 in vulnerable groups, continued Access is important even as the virus recedes from daily life. Department of Infectious Diseases at Children’s Hospital of Philadelphia.
The virus is not over yet, he said, noting that it is likely to circulate for decades. People at highest risk of serious illness need to make sure that if they have an upper respiratory infection they get themselves tested, and if they test positive very early in the course of their illness, they need to take Paxlovid to help. life. .
Paxlovid is available by prescription and should be taken within the first 5 days of symptoms.
Covid-19 appears to be receding in the US after virus-related hospitalizations peaked in early September. Previous years have seen similar late-summer surges, often followed by Bigger waves come around the end of the year. However, it is unclear what pattern will take place this winter.
Other serious respiratory viruses are just starting to appear. Levels of respiratory syncytial virus, or RSV, appear low nationwide but have increased in the South, especially in Florida. According to data from the US Centers for Disease Control and Prevention, flu levels remained low or minimal in all states except Alaska, where levels were moderate, during the first week of the virus. October.
This season is the first to offer protection against all three major respiratory viruses, flu, Covid and RSV, and CDC recommends protection against all three for all people. eligible.
Two RSV vaccines have been approved this year for adults 60 and older, and one RSV vaccine has been approved for use during pregnancy to protect babies early in life. An RSV protective antibody shot has also been approved for infants, and is recommended by the CDC for all children under 8 months of age and for some older children who are more susceptible to severe illness.
An updated Covid-19 vaccine designed to protect against recently circulating strains is also available, and the CDC recommends it as well as seasonal flu vaccination for everyone starting at 6 months. age or older.
Covid-19 vaccines also increased in price after the US government stopped widely providing them. Pfizer, Moderna and Novavax shots cost between $15 and $30 in bulk government contracts during the pandemic, and the companies have increased prices about fourfold, to $115 to $130. per dose, after the US moves out of the system. in which the government pays for the shots.
The vaccines are still expected to be covered by insurance, but some people experienced unreasonable out-of-pocket costs in the early days of the rollout in the fall when insurance through the commercial marketplace was established. apply.
Doctors worry that the higher price for Paxlovid could also cause problems.
“By making it more expensive, it just creates a huge obstacle,” Offit said. Do I think that would limit absorption? I agree.
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