Pfizer to Charge Nearly $1,400 for COVID-19 Drug Paxlovid

Pfizer projects Paxlovid sales to fall by 58 percent this year compared to 2022.
Pfizer to Charge Nearly $1,400 for COVID-19 Drug Paxlovid
A box of Paxlovid, Pfizer's COVID-19 pill. (Jennifer Lorenzini/Reuters)
Naveen Athrappully

Pfizer plans to charge almost $1,400 for its COVID-19 antiviral drug Paxlovid, which comes at a time when the company is expecting lower sales of its COVID-19 products.

The five-day course of Paxlovid will be priced at $1,390 when it transitions to the commercial market, a Pfizer spokesperson told CNBC on Oct. 18. This is more than 2 1/2 times higher than the $529 price that the U.S. federal government paid for the drug. Since December 2021, the government has purchased Paxlovid and distributed it for free to the public. However, beginning next year, Pfizer will sell the drug directly to health insurers.

While Paxlovid will be priced at $1,390, this may not be the final price paid by customers. The price doesn’t include rebates and other discounts to insurers and middlemen.

The company is trying to secure health coverage for Paxlovid to drive down out-of-pocket costs. Pfizer also intends to provide assistance with copays for qualifying individuals.

“Pfizer’s goal is to ensure broad and equitable access to our medicines. We are working diligently with payers to achieve the best possible formulary placement for Paxlovid, resulting in low [out-of-pocket] costs for patients,” a spokesperson for the company told the news outlet.

People who already have Medicaid or Medicare can get Paxolovid for free through 2024, according to the Department of Health and Human Services. This program can extend through 2028 for those who are uninsured or underinsured.

The company claims that its copay assistance program for privately insured patients could result in such individuals paying “as little as $0” through 2028, according to Axios. Paxlovid will continue to be free until the end of 2024 for people who get it through the government’s free distribution program.

Some health experts have questioned the steep cost of Paxlovid. “Wasn’t worth it for majority at $500. Definitely not worth it at $1,390,” Dr. Anil Makam, an associate professor of medicine at the University of California–San Francisco, said in an Oct. 19 post on X, formerly known as Twitter.

“Better than $2,500, but still way too expensive for the 2020s’ version of Tamiflu,” Dr. Todd C. Lee, an attending physician at the McGill University Health Centre in the Department of Medicine, Canada, said in an Oct. 19 X post.

“Nevermind that the trial in vaccinated people was stopped for futility and didn’t demonstrate benefit. And that was pre omicron, pre boosters, and excluded people previously recovered. Wasn’t financially viable at $530,” he wrote in an earlier X post.

Pfizer’s decision to set Paxlovid’s price at $1,390 comes as the company recently slashed its revenue and profit estimates for 2023 because of a steep drop in demand for COVID-19 vaccines and other products.

The company now expects its 2023 sales to be in the range of $58 billion to $61 billion, down from the previous forecast of $67 billion to $70 billion. The company reduced its guidance for Paxlovid by about $7 billion for the year.

“The global utilization rates for Paxlovid are currently trending slightly above last year’s utilization but lower than our original expectations,” the company said in an Oct. 13 statement. In August, Pfizer projected Paxlovid sales to fall by 58 percent this year as compared with 2022.

Pfizer shares were trading at about $31 as of 4 p.m. EDT on Oct. 19. Year to date, the stock is down by about 40 percent.

Last week, the U.S. government arranged to return 7.9 million courses of Paxlovid out of the 24 million courses it had purchased from Pfizer.

Paxlovid is a combination of two medications, nirmatrelvir and ritonavir, which are taken together as pills within the first five days of the onset of COVID-19 symptoms.

Clinical Trials and Side Effects

Clinical trials of Paxlovid have produced mixed results. In one of Pfizer’s clinical trials, Paxlovid was shown to minimize deaths and hospitalizations by about 90 percent among unvaccinated individuals who were at risk of serious COVID-19 illness.

However, another trial from the company didn’t show any benefit to individuals deemed to be at standard risk of COVID-19 infection, including those who had been vaccinated.

The Pfizer pharmaceutical company logo is displayed at Discovery Park in Sandwich, England, on Aug. 17, 2011. ( Dan Kitwood/WPA Pool/Getty Images)
The Pfizer pharmaceutical company logo is displayed at Discovery Park in Sandwich, England, on Aug. 17, 2011. ( Dan Kitwood/WPA Pool/Getty Images)

Paxlovid comes with the risk of several side effects. According to Pfizer, Paxlovid “may cause side effects, some of which may be serious.” It can trigger allergic reactions such as blisters, peeling skin, ulcers in the mouth, throat, or genital area, trouble swallowing, and swelling of the lips, tongue, and face.

The drug can also cause liver problems. Pfizer warns people to not take Paxlovid if they have symptoms of liver issues such as itchy skin, loss of appetite, dark-colored urine, and pain in the stomach area.

Other potential side effects of the drug include headache, vomiting, high blood pressure, and nausea. The most common side effects are diarrhea and a change in the sense of taste.

There are also concerns about a dangerous interaction between Paxlovid and other medications. A paper published in October 2022 in the Journal of the American College of Cardiology showed that a combination of nirmatrelvir and ritonavir, or Paxlovid, can interact with several commonly prescribed cardiovascular medications.

The paper stated that researchers had found that interactions between Paxlovid and some blood thinners could result in a higher risk of bleeding. Paxlovid’s interactions with cholesterol medications such as statins can potentially be toxic. Researchers warned that interactions between certain blood pressure medications and Paxlovid may lead to adverse reactions.

The Food and Drug Administration granted full approval for Paxlovid in May. The agency said that Paxlovid was the fourth drug and first antiviral pill to be approved for treating COVID-19.

The full approval is applicable only to adults. Adolescents ages 12 to 18 will have access to the drug under emergency use authorization.

As Paxlovid comes with multiple drug interactions, the medication will have a black box warning clarifying its potential to interfere with other drugs.

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