Pfizer told pharmacies and clinics this week it will soon price a five-day course of COVID-19 treatment Paxlovid at almost $1,400, more than two-and-a-half times what the federal government has paid for the antiviral pills.

The Wall Street Journal first reported Wednesday that Pfizer plans to price a course of the oral antiviral at $1,390, far higher than the U.S. had paid at $529. The drug was authorized in the U.S. in 2021 and quickly became a key tool to help treat those at risk of developing severe infections from COVID-19.

While the figure will be the drug’s list price on the commercial market, many health plans will likely negotiate far better terms that will limit copays or out-of-pocket charges for people who need the pills, the Journal reported.

Those on Medicare, Medicaid and the uninsured will also still be able to access Paxlovid via the Department of Health and Human Services for free through the end of 2024. HHS added that Pfizer would run a program between 2025 and 2028 for un- and underinsured people to help assist with the cost.

But as Axios notes, the list price on the commercial market could make it more difficult for patients to access the drug. The U.S. has so far maintained the exclusive purchasing agreement with Pfizer for Paxlovid.

“Pricing for Paxlovid is based on the value it provides to patients, providers and health care systems due to its important role in helping reduce COVID-19-related hospitalizations and deaths,” a spokesperson for Pfizer told the Journal, adding that many people will pay “as little as $0” under the copay assistance program through 2028.

Multiple studies have shown reductions in hospitalization for adults who test positive for COVID-19 and are treated with Paxlovid. The Food and Drug Administration gave its full approval to Paxlovid in May, advising treatment for adults with high risk of getting severely ill from COVID-19.

Pfizer recently cut its sales forecast for the year due to a plunge in Paxlovid prescriptions and sales of its COVID-19 vaccines. Company CEO Albert Burl said recently the U.S. was “in the middle of COVID fatigue, where everyone wants to forget about the disease.”

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