Pfizer P drug "soul bargain" negotiations failed! Azvudine in health insurance: let more patients use it

In 2021, the famous scene of "soul haggling" where 700,000 sky-high drugs were cut to more than 30,000 yuan is still fresh
in memory.
According to the concept of the Medical Insurance Bureau that "every small group should not be abandoned", several rare disease drugs with an annual treatment cost of more than one million yuan this year are still the main play
.
Also of particular concern in this medical insurance negotiation is the list of
new crown treatment drugs.

Figure 1 The famous scene of "soul bargaining" (Source: CCTV News screenshot) With the liberalization of epidemic control in December 2022, Pfizer's new crown oral drug nematevir tablets/ritonavir tablet combination (hereinafter referred to as "Paxlovid") is difficult to find! Paxlovid priced at 2980 was even speculated to 15,000 yuan a box by the scalper market, and this new crown oral medicine was pushed to the forefront
overnight.
However, the high-profile Paxlovid failed in the medical insurance negotiations after all, and will not be able to enter the 2022 national medical insurance drug list
.
According to the latest news, the negotiation of the 2022 national medical insurance drug catalogue officially ended
on January 8, 2023.
This year, a total of 3 new crown treatment drugs, Azvudine tablets, Paxlovid and lung cleansing and detoxification granules, participated in the negotiation through the
procedures of self-declaration, formal review, and expert review.
Among them, the negotiation of azvudine tablets and lung cleansing and detoxification granules was successful, and Paxlovid failed to succeed
due to the high quotation of the manufacturer Pfizer.

Figure 2 Negotiations on new crown treatment drugs (Source: [2])

The relevant person in charge of the National Health Insurance Administration said that although Paxlovid could not be included in the medical insurance catalogue through negotiation, according to the requirements of the "Notice on Optimizing the Medical Security Related Policies for the Treatment Costs of Patients with Novel Coronavirus Infection after the Implementation of "Class B and B Tubes" jointly issued by the National Health Insurance Administration and relevant departments, including Paxlovid, azvudine tablets, monoravir capsules, cold and wet granules, etc
.
, medical insurance will be temporarily paid until March 31, 2023.
During this period, insured patients with new coronavirus infection can enjoy medical insurance reimbursement policies for these drugs
.
Why is Paxlovid reluctant to "lower his profile"?

Why is Paxlovid reluctant to "lower his profile"? Some business people familiar with the new crown oral drug have made an analysis of this, first, the drug is in short supply, and pharmaceutical companies do not worry about selling; Second, Pfizer is unwilling to undermine its own global price system; Third, the drug has shown certain advantages in terms of efficacy, and has also become the preferred drug for the treatment of the new crown, even if the price is not reduced, it is expected that the drug will still have a lot of demand space in the use of subdivided populations
.

Before the start of the national medical insurance negotiations, Pfizer Paxlovid has been temporarily included in the payment scope of some local medical insurance, and the medical insurance payment price has been reduced from 2300 yuan per box to 1890 yuan per box
.
However, the temporary payment period for this medical insurance is only until March 31 this year
.
In other words, from April, patients need to use the drug completely at their own expense
.
Nearly 2,000 yuan a box of drugs, for most people, the price is still expensive
.
Pfizer Paxlovid participates in the national medical insurance negotiation, and if it can smoothly enter the national medical insurance catalogue through negotiation, it is also the process of "price for quantity" for drugs [1].

On December 30, 2022, the State Food and Drug Administration approved the import registration of Merck's drug monogravir with emergency conditions; The Sino-Japanese joint venture Ping An Shionogi began to submit preparatory materials related to the application for marketing authorization of new crown oral drugs, and its parent company Shionogi obtained emergency marketing authorization
in Japan in November.
In addition, there are at least 16 domestic new crown oral drugs under development, of which Junshi Biologics and Pioneer Pharmaceutical have disclosed some phase III clinical data
.
Azvudine into medical insurance real biology Liu Yong: I didn't consider too many interest issues, but there is another piece of good news, Azvudine tablets medical insurance negotiations were successful and successfully included in medical insurance
.
Liu Yong, vice president of Real Bio, said, "In fact, we are not under great pressure, because we have not put corporate interests first in this medical insurance negotiation, and more consider the accessibility of azvudine and fulfill corporate social responsibility
.
" Liu Yong said that in general, we are willing throughout the whole process, have been fully prepared to reduce prices, and the purpose of participating in medical insurance negotiations is also to make more Chinese people can afford this drug
.
It is reported that the indications of azvudine for the treatment of the new crown were only approved in July 2022, and this medical insurance negotiation only covers the indications for the treatment of AIDS
.
Liu Yong said: "Although this time is to talk about AIDS indications, because the drug involves the particularity of new crown treatment, this pricing will also affect the pricing
of new crown treatment.
" "Azvudine is a broad-spectrum RNA virus inhibitor that specifically acts on SARS-CoV-2 polymerase (RdRp) and embeds viral RNA in the RNA synthesis process of SARS-CoV-2, thereby inhibiting SARS-CoV-2 replication and treating SARS-CoV-2 infection
.
Azvudine differs from the Paxlovid technical route in that it is a broad-spectrum RNA viral inhibitor
.
The difference between the two drugs can be popularly understood as that Paxlovid is a bullet, accurately hitting the new crown virus; Azvudine is a cannon, blowing up all the same viruses [3].

Clinical results have proved that azvudine can significantly shorten the nucleic acid conversion time, accelerate virus elimination, significantly reduce viral load, reduce symptoms and shorten the course of disease in patients with mild and moderate SARS-CoV-2 infection, and has good safety and no significant impact on liver and kidney function of patients, which is safe and effective
.
The limitations of azvudine are that the time to market is short, the study of drug interactions and contraindications is not perfect, and the risk of self-medication is greater
.
Patients with liver function impairment, renal impairment, pancreatitis, viral hepatitis, severe opportunistic infections or opportunistic tumors, more serious chronic diseases, metabolic diseases (such as diabetes), neurological and psychiatric diseases must be used
under the guidance of a clinician.
Be sure to consult your attending physician before medication to avoid adverse reactions
.
Based on the above, in order to meet the needs of the treatment of patients infected with new coronavirus infection in various places, the medical insurance departments in various places have recently temporarily included a batch of new crown symptomatic treatment drugs into the payment scope
of local medical insurance in combination with the operation of local medical insurance funds.
In general, medical insurance reimburses a wide
range of drugs for the treatment of new coronavirus infection.

Resources:

[1]https://mp.
weixin.
qq.
com/s/za6JFnGYONtT1K9EBpf1KQ[2] https://news.
ifeng.
com/c/8MQ0DMi7ab9