COVID is again visiting the retirement community where I live sparking the anxieties of elders and vulnerable residents. But garden variety fears spiked into shock when people discovered the cost of Paxlovid had skyrocketed. A quick check with Professor AI told me that the retail price today without insurance ranges between $1,400 and $2,000 for a standard course of 30 pills. I’ve been fortunate, so far, to not have had COVID, so I didn’t know that during the pandemic health emergency Paxlovid was free. Beginning in December 2021 the government started purchasing the treatment courses from Pfizer and distributing them for free throughout the height of the pandemic.
On March 29, 2023 the U.S. Senate passed a resolution to end the COVID-19 national emergency. In May of that year Pfizer announced that the FDA had approved Paxlovid. I’m naive about the way things work between the government and industry, so at first I was puzzled: Wasn’t the drug approved in 2021 when the government was purchasing it? Well, what I didn’t understand is that approval means now Pfizer can sell the drug at list price. It was free to transition the drug to the commercial market and set the list price between $1,390 and $1,800 for a five-day treatment course. And the full cost now fell on the public.
At first health insurance companies intervened to keep costs low or free through insurance coverage and manufacture co-pay assistance programs. There were insurance negotiations that lowered out-of-pocket costs at pharmacies, but insurers passed the higher cost along in the form of increased premiums. Through certain plans elders on Medicare and Medicaid could still receive Paxlovid at no cost until Dec. 31, 2025. At New Year’s Eve, 2026 COVID came again to my community.
I called my prescription drug company, Humana, and inquired what my co-pay would be — $834 for the 5-day treatment, 30 pills. The people living here are well provided for, but even so that’s a substantial amount to dole out for a single purchase, and those who are compromised in some way probably don’t feel they have a choice. What about those equally compromised for whom $834 is not possible, or maybe just not reasonable? We are brought nose-to-nose with an unconscionable situation. I checked with Professor AI again to see how Pfizer justifies the cost. The response was: Cost is based on Value to Patients. Something was mentioned about value to health care providers — because they have something, albeit obscenely expensive, to keep their patients, hopefully, from dying? Also mentioned is the standard commercial market model “where prices are initially set high before negotiations, rebates, and discounts, etc. take effect.” Which means aim for the moon so the percent reduction will still leave you a fine profit. Also understood: Get as much as the market, in this case sick, frightened people, will bear.
To me there’s always been something deeply disturbing about capitalism’s relationship to people. They are simply the cogs that make the wheel go round for the people who own the wheel. Health care in the United States is a capitalist enterprise, and it doesn’t seem farfetched to view patients as the cogs in health care’s wheel. What would happen if there suddenly were no sick people? Well, the industry knows it doesn’t need to worry about that, so it goes along happily with the mantra If you want it badly enough, you’ll pay for it. Pfizer et al., you’re sick.
Kathy Gregg lives in Amherst.