Seniors on Medicare will continue to have free access through 2024 to the go-to treatment for COVID-19 infections, Paxlovid, which has shown to significantly reduce the risk of serious illness and death among older people.
This is the result of an agreement between the U.S. Department of Health and Human Services (HHS) and the drug’s manufacturer, Pfizer Inc. The plans were announced after Pfizer had said that it would be moving the drug to the commercial market and charging for it, starting Jan. 1, 2024.
Pfizer plans to charge $1,390 for a standard five-day course during 2024. It’s too early to say how much seniors on Medicare will pay out of pocket from 2025 onwards.
Up until now, the U.S. government has been purchasing Paxlovid to ensure free access to the drug as part of a partnership between HHS and the Pfizer over the past three years that enabled the development, manufacture and distribution of COVID-19 vaccines and therapeutics.
The federal government has purchased nearly 24 million courses of Paxlovid at about $530 per course. At the end of this year, HHS will return an estimated 7.9 million courses of the drug to Pfizer for a credit of about $4.2 billion, under the agreement with the drug-maker.
This credit will be used for future therapies that the agency may purchase from Pfizer. It will also be used to continue offering free courses under the new agreement with Pfizer to Medicare recipients through 2024, and uninsured individuals through 2028.
The announcement comes as the country transitions from federal coverage for COVID-19 vaccines and treatments to coverage by private payers — health insurers, employers and individuals.
Paxlovid
Paxlovid is a pill taken orally to treat mild-to-moderate COVID-19 in adults at high risk for severe disease, including hospitalization and death. The drug also remains available to everyone 12 and older. It showed an 89% reduction in the risk of hospitalization and death in unvaccinated people in a clinical trial.
The dosage is three Paxlovid pills taken twice daily for five days, for a full course that adds up to 30 pills.
To be effective, Paxlovid must be taken within five days of the onset of COVID-19 symptoms, according to recommendations issued by the Food and Drug Administration. Due to that extraordinarily short time frame, HHS has recommended that state-licensed pharmacists be authorized to prescribe the drug to expand access.
Privately insured individuals will likely pay a fraction of the $1,390 Pfizer plans to charge commercially for a full course of treatment, depending on their coverage.