In a meeting with healthcare providers, leaders from the US Department of Health and Human Services (HHS) went over ways to minimise the out-of-pocket expenses for Pfizer’s Covid-19 drug Paxlovid (nirmatrelvir/ritonavir).  

The virtual meeting, which took place on 22 January, with the American Medical Association, American Academy of Family Physicians, and other healthcare provider groups centered on integrating oral antivirals, including Paxlovid, into the commercial market for managing Covid-19. 

In October 2023, Pfizer announced that it will set the US price for Paxlovid at nearly $1,400 per five-day course when it moved over to commercial sales at the beginning of 2024. This is nearly triple what the US government paid at approximately $530 per course. During this meeting, HHS emphasised the commitment to ensuring patients in the US face no financial barriers, while extending cost-free access for Medicare, Medicaid, and uninsured individuals until the end of this year. 

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) provided guidelines for Medicare Part D plans, allowing enrolees to obtain Paxlovid without opting for Pfizer’s patient assistance programme PAXCESS, an initiative designed to assist patients in accessing Paxlovid. 

However, the path to marketing Paxlovid has not been smooth. On 13 October 2023, Pfizer announced that the US Government was returning nearly eight million courses of Paxlovid labelled under an emergency use authorisation, in place of credit for commercial doses that were labelled as per its full approval. The move reduced Pfizer’s 2023 revenue expectations for Paxlovid by around $7bn, including a $4.2bn revenue reversal. 

Pfizer had announced an agreement the same day that all those on Medicare, Medicaid, and those who are uninsured will continue to be able to access Paxlovid free of charge until the end of this year. The recent discussion is part of an ongoing initiative to inform providers, address concerns, and sustain widespread access to oral antivirals during the transition to commercial availability.  

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By GlobalData

Paxlovid is a combination of Pfizer’s investigational antiviral nirmatrelvir (PF-07321332) and a low dose of ritonavir, an antiretroviral medication traditionally used to treat HIV. Nirmatrelvir binds directly to the SARS-CoV-2 Mpro active site and inhibits the viral replication process while ritonavir is given to boost the pharmacokinetics of nirmatrelvir. 

According to GlobalData’s Pharma Intelligence Center, Paxlovid will generate $4.8bn in sales by 2029. Peak sales of Paxlovid were in 2022, with $18.9bn globally, as per Pfizer’s annual 2022 financial report. 

GlobalData is the parent company of Pharmaceutical Technology. 

The US Food and Drug Administration (FDA) approved Paxlovid in December 2021 for emergency use, with the agency granting full approval in May 2023 for adults at high risk of progression to severe Covid-19.