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The estimated production cost of Paxlovid: $13. Its new list price: $1400.

Pfizer is once again looking to extract huge profit margins from a life-saving Covid treatment.

Pfizer’s Covid antiviral drug Paxlovid is an important medicine. Doctors can prescribe it to help Covid patients significantly reduce their odds of hospitalization, death and long-term health problems. Despite its efficacy, it’s already not being prescribed as often as it probably should be.

That’s why it’s so depressing to hear that Pfizer is planning to price a five-day course of Paxlovid at $1,390 when it enters the commercial market later this year. That’s more than double the $529 it was charging the U.S. government, which has been purchasing the medicine from Pfizer since 2021 and freely providing it to patients. Harvard University researchers estimate the cost of production for a 5-day course of the drug is about $13. 

While many people will not be affected by the change in list price, some people are likely to find it harder to access the drug in the future.

There’s nothing unusual about pharmaceutical companies extracting extraordinary profits from drugs by posting astronomical list prices. But that doesn’t make it any less gross to watch, particularly given how familiar everyone is with the dangers of Covid for high-risk populations. While many people will not be affected by the change in list price, some people are likely to find it harder to access the drug in the future and, thus, be deprived of a great tool for lowering the risk of serious illness from a dangerous virus.

According to The Wall Street Journal, health plans will make it so that “most patients will have a small or no out-of-pocket cost because Pfizer is expected to offer price discounts and help patients with their out-of-pocket charges.” But the high list price might still make insurance companies stingier about covering it, thereby limiting access to it. David Boulware, a professor of medicine at the University of Minnesota Medical School, told The Wall Street Journal, “With a low cost medicine, they’re not going to aggressively police it, but a higher price medicine they likely would.”

CNN notes that the Department of Health and Human Services said that people on Medicare, Medicaid or who lack insurance will be able to get Paxlovid for free through 2024, and that Pfizer says that the program will continue through 2028 for those who are uninsured or “underinsured.” But it’s unclear who qualifies as “underinsured.” Might there be people for whom Paxlovid is far too expensive under their insurance policy who won’t qualify? What happens to people with high deductibles? What happens after 2028? What we do know is that patience assistance programs can be a marketing gimmick to help justify exorbitant prices and that higher prices are going to make it so that many people who need the drug are less likely to be able to get it.

Paxlovid’s price hike mirrors Big Pharma’s price hikes for Covid vaccines, and the price hike has been appropriately slammed by Democrats and by public health advocates. “Life-saving medication is a necessity, not a luxury,” Rep. Ro Khanna, D-Calif., posted on the social media platform X on Friday. “We need to cap what Big Pharma charges for medication to ensure everyone who needs it can get it.”

Posting a high list price for a drug has global implications. The World Health Organization recommends Paxlovid as the preferred antiviral treatment for Covid, and there was already a problem of the drug being out of reach for millions of high-risk people in lower-income countries. This price hike is going to make that problem worse. “Drug corporations’ high prices, contract secrecy and monopoly supply all suppress demand, and make it harder for resource-starved health agencies to purchase the treatment they need to care for people,” Peter Maybarduk, director of the Access to Medicines program at Public Citizen, said in a recent statement.

Pharmaceutical companies often justify their high profit margins by claiming that they’re necessary for the research and development of the drugs in the first place. The problem is that when there’s no cap on profit maximization and our insurance system is riddled with cracks, the drugs end up out of the reach of many of the people they’re supposed to help.