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Frustration grows over shortage of medicines for covid-19 in China

2023-01-14T17:14:55.773Z


The Chinese government did not reach an agreement with Pfizer to include the treatment against covid-19 Paxlovid in its national insurance plan. Officials said the drugmaker's asking price was too high. In the background, there is a global crisis over patents and the supply of medicines. 


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(CNN) --

As Jo Wang, an event planner in Beijing, watched her family members fall ill with Covid-19 one by one late last month, she thought of only one thing: finding antiviral pills to protect her old grandmother when it was her turn.

After three days of trying and failing to buy a box of Pfizer's Paxlovid, Wang got lucky on an e-commerce platform where he got Covid-19 treatment through an official channel.

She bought it on the fourth day and received it in the mail on the sixth.

But Wang, who was breaking the rules by looking up the recipe on her own before her grandmother fell ill, was also wracked with guilt.

“I felt very bad at that moment… you don't know how many days it will take to buy this medicine, it's completely unknown.

And you don't know how long the people in your family will take it," she said, emphasizing her fear that if she waited until the 92-year-old woman fell ill, it would be too late to get the pills, which are most effective in the early stages of the disease.

“It is a very desperate situation,” she added.

Wang is not alone in trying to obtain Western drugs amid a wave of Covid-19 overwhelming China, increasing demand for treatments, especially for the country's large unvaccinated elderly population.

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In recent weeks, many have turned to the black market, where street vendors claim to sell Covid-19 treatments ranging from illegal imports of the Indian-made generics of Pfizer's Paxlovid and Merck's molnupiravir to the legitimate product, but at nearly eight times the market price.

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Growing frustration over shortages was compounded by an announcement on Sunday that the government had not reached an agreement with Pfizer to include Paxlovid in its national insurance plan.

Officials said the drugmaker's asking price was too high.

The decision could mean that after March 31, the drug will only be available to those who can pay full price, with current rates hovering around 1,900 yuan ($280).

Paxlovid has been shown to reduce the risk of death and hospitalization in high-risk patients when used soon after the first symptoms appear.

Last February, the drug — widely used in developed countries — became the first oral pill specifically for covid-19 to be licensed in China.

China agreed to cover two other Covid-19 treatments in recent talks: the traditional Chinese medicine Qingfei Paidu and the self-made antiviral pill Azvudine.

There is limited data on how well Azvudine protects against serious diseases.

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The price trap and shortages, nearly a year after the pill was first licensed and months after Pfizer selected a national drugmaker for local production, show the challenge China faces: demand for treatments for its population of 1.4 billion increases after the government decided to lift the restrictions of the zero covid policy last month.

prized pill

The imported Pfizer pill is currently available at community hospitals in some cities, including Beijing, Shanghai, Tianjin and Guangzhou, according to state media.

It is also sold on various e-commerce platforms, where there are local reports suggesting that supply restrictions are being eased.

But there are questions about how widely the pills will be distributed in China and whether there are enough medical resources to prescribe them, an urgent problem as the outbreak moves from urban centers to smaller cities and rural China.

Experts say the pills are more readily available at hospitals in better-resourced major cities and harder to find elsewhere.

On Monday, Pfizer CEO Albert Bourla said the company had ramped up exports, shipping millions of doses of Paxlovid to China in the past two weeks, and was working with its domestic partner Zhejiang Huahai to manufacture Paxlovid in China in the first half of this year, according to Reuters.

But speaking at a conference in San Francisco, Bourla also dashed hopes that the company could strike a deal with China for domestic drugmakers to produce a generic version of the drug for sale in the country, denying a Reuters report. on January 6 that such an agreement was being discussed.

Covid-19 outbreak in China.

US-based Merck, known internationally as MSD, said on its WeChat account on Wednesday that it will take legal action against some manufacturers who are supplying unauthorized versions of its Covid-19 drug.

The company said it would also partner with domestic firm Sinopharm to supply China with its pill, which is sold under the brand name Lagevrio.

Neither Western firm currently holds a patent for the drugs in China, according to a WHO-affiliated database, although both have already applied for one.

But as shortages press on — and with it cost problems — in one of the world's largest generic drug-producing countries, so too are global problems related to intellectual property rights, according to experts who They study access to medicines.

Two Chinese companies poised to make generic versions of Paxlovid have already submitted their products for evaluation by the World Health Organization (WHO), according to the WHO-affiliated Medicines Patent Pool (MPP). , a sign that they are ready to start producing the drug.

Those companies, Zhejiang Huahai and Apeloa Pharmaceutical, along with two others in China, received sublicenses in 2022 to make the full generic pill that could serve 95 low- and middle-income markets, excluding China, under an earlier agreement between Pfizer and the MPP, an organization that facilitates access to treatment for people in poorer countries.

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“At the scale of the health crisis taking place (in China), the next logical step (would be) for these licenses to be expanded to include allowing domestic supply in China, including from other producers (in the region),” said Ellen 't Hoen, former executive director of MPP and current head of the Drug Law and Policy project.

However, if the drug developer is not willing to take that step, as Bourla indicated was the case with Pfizer on Monday, China could take some steps, such as pledging to protect companies that make generic supplies or import generics from other countries. places, using legal measures allowed under the World Trade Organization rules during health emergencies, 't Hoen said.

That potential has been discussed in public forums in China.

Commentators there note that the country does not have a history of using these flexibilities, which countries often use cautiously, given their potential to irritate foreign pharmaceutical companies and the countries in which they are based.

In China, the government's reluctance to resort to such measures is linked to concerns about the impact it could have on the local economy, where foreign pharmaceutical companies are major employers, said Yanzhong Huang, a senior fellow at global health at the Council on Foreign Relations in New York.

Beijing this month called on authorities to improve supervision of online drug sales and crack down on price gouging, misleading advertising and intellectual property infringement.

Pfizer talks cost stagnation

China may be waiting for more domestic antiviral pills in development to fill the gap.

Throughout the pandemic, health regulators have generally opted for local tools to deal with the virus, and Beijing has yet to approve a foreign covid vaccine.

Health officials recently tried to ensure affordable access to treatment for the public and to minimize the potential impact of the government's decision not to include Paxlovid in its national insurance plan.

A senior health official said on Wednesday that hundreds of pills to relieve Covid symptoms were already covered by insurance and new viral treatments were in the works.

The nationalist state-run tabloid Global Times published an opinion piece on Monday blaming the "forces of American capital" for China's inability to reach an agreement with Pfizer to include the pills in national insurance.

“Over the past few days, a growing number of US politicians and media outlets have been making strident 'warnings' about the epidemic in China... If they care so much, why doesn't Pfizer stop looking for profit and cooperate with China with a little more sincerity?, said the article in question.

Bourla said Monday the talks broke down after China requested a lower price than Pfizer charges most lower-middle-income countries.

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In a separate statement to CNN, Pfizer declined to comment on what price it had offered, but said the company "will continue to engage with the Chinese government and all relevant stakeholders to ensure an adequate supply of Paxlovid in China" and that it remains " Committed” to meeting the COVID-19 treatment needs of Chinese patients.

But for those who have been grappling with the immediate problems of getting access to medicine for themselves and their families, like Wang in Beijing, there is a sense, at least for now, that the system isn't working.

"It's cruel... no matter how we feel, there's nothing we can do," he said.

“It is not the case that your effort can improve the situation.”

CNN's Cheng Cheng contributed reporting.

chinacoronavirus

Source: cnnespanol

All news articles on 2023-01-14

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