Pfizer Will Charge Patients $1,390 for COVID Anti-Viral Paxlovid

Pfizer, Inc. plans to charge consumers more than double the price charged to the U.S. government for its COVID-19 anti-viral drug nirmatrelvir-ritonavir, sold under the brand name Paxlovid. A five-day course of the drug to treat COVID will soon cost patients $1,390.  According to researchers, it costs Pfizer $13 to manufacture the supply of pills for a five-day course of treatment, making the price the company charges patients 100 times more than the cost of production.¹

The U.S. government, which had previously been the sole supplier of Paxlovid, bought approximately 24 million courses of the drug at $530 each, for a total cost of about $127,200,000,00.^{2 3} The government supplied the drug to patients for free during the pandemic.⁴

Many health professionals doubt the benefits of Paxlovid, especially with the new high price tag. Anil Makam, MD, associate professor of Medicine at the University of California-San Francisco wrote on a Twitter that Paxlovid “wasn’t worth it for majority at $500. Definitely not worth it at $1,390.”⁵

Pfizer’s Paxlovid Drug to Treat COVID Has Serious Side Effects

The U.S. Food and Drug Administration (FDA) granted Pfizer an Emergency Use Authorization (EUA) to distribute Paxlovid in late 2021. By the time the anti-viral drug received full FDA licensure in May 2023, more than 11 million prescriptions had been filled. Adult patients with COVID, who are at risk of severe symptoms from the disease, and of being hospitalized and possibly dying, have been given full FDA approval to take the drug.⁶

Drug trials for Paxlovid have shown conflicting results. In clinical trials, the drug appeared to decrease hospitalizations and death by as much as 90 percent in unvaccinated individuals at high risk for COVID complications. Another trial showed no benefit to those who had been vaccinated and were considered to have a standard, rather than high, risk of severe COVID.

Paxlovid does not come without the risk of side effects, some of which may be severe. Side effects include allergic reactions, such as trouble swallowing, swelling of the lip, tongue and face, ulcers in the mouth, throat and genitals, blisters and peeling skin, along with liver problems, headache, vomiting, nausea, diarrhea, alteration in the sense of taste and blood pressure changes. The drug has also been shown to have interactions with various medications.⁷

In addition, COVID patients who take Paxlovid are at risk of suffering a rebound infection two to eight days after completing the five-day course of medication. Many patients initially feel better after a course of Paxlovid, then either come down with COVID symptoms or test positive for the SARS-CoV-2 virus about a week later.⁸

Pfizer Expects Profits from Paxlovid to Decline in 2023

While patients may actually pay less than the list price of Paxlovid due to rebates and other discounts, the high cost of the drug will affect the uninsured and increase out-of-pocket costs for insured patients.⁹

Pfizer has reached an agreement with the U.S. Department of Health and Human Services (HHS) to transition Paxlovid from the government to the direct-to-consumer market. The agreement provides that both uninsured and Medicaid/Medicare patients will continue to receive Paxlovid without cost until the end of 2024. The federal program will be extended through 2028 for the underinsured and the uninsured. HHS will also purchase an additional one million Paxlovid treatments as a stockpile in the event there is another surge in COVID cases.¹⁰

A Pfizer spokeswoman said:

Pricing for Paxlovid is based on the value it provides to patients, providers, and health care systems due to its important role in helping reduce COVID-19-related hospitalizations and deaths.¹¹

Pfizer’s sales revenue in 2022 hit a record $100 billion, due largely to the COVID pandemic. The pharmaceutical giant earned $37.8 billion from sales of its Comirnaty messenger RNA (mRNA) COVID shots and $18.9 billion from Paxlovid. The combined sales of Comirnaty and Paxlovid alone was higher than Pfizer’s total sales revenue in 2019.¹² The federal government gave a $445 million dollar grant to Pfizer and Pfizer’s business partner, the German pharmaceutical BioNTech SE, to aid in the development of Comirnaty mRNA COVID shots.

In August 2023, Pfizer projected that sales for Paxlovid would decrease by 58 percent compared to 2022. Pfizer has downgraded its expectations for 2023 sales, and now expects its full-year sales of Paxlovid to decrease by about $7 billion and sales of Comirnaty to drop by about $2 billion due to the general decline in public demand for COVID-related pharmaceutical products.^{13 14}

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