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Pfizer said it will set the U.S. price for its COVID-19 antiviral treatment Paxlovid at nearly $1,400 per five-day course when it moves to commercial sales after government stocks run out, more than double what the government currently pays for it.

The new list price, which does not include rebates and other discounts to insurers and pharmacy benefit managers, is $1,390 per course, Pfizer said in an emailed statement. The U.S. government paid around $530 per course for Paxlovid it has made available to Americans at no cost.

Paxlovid, the most commonly prescribed at home treatment for COVID-19 in the U.S., will remain available for free to patients there until the end of the year, Pfizer said.

Under an agreement with the government, the drug will also stay free of charge for patients insured under the Medicare and Medicaid programs through the end of 2024, and to uninsured and underinsured patients through 2028.

In Pfizer’s clinical trial, Paxlovid was shown to reduce hospitalizations and death by around 90% for unvaccinated people at risk for serious disease. In another trial, Pfizer was not able to show benefit for those considered at standard risk, including vaccinated patients.

Influential U.S. drug pricing watchdog the Institute for Clinical and Economic Review (ICER) said last year that its suggested price range for Paxlovid based on the benefits and value to patients was between $563 to $906 per course.

The United States purchased around 24 million courses of the oral two-drug treatment from Pfizer, and still had a large supply, but arranged to return 7.9 million courses last week. The company also slashed its full-year revenue forecast due to lower-than-expected sales of its COVID-19 products.

Under that deal, a credit for the returned Paxlovid doses will pay for the supply to Medicare, Medicaid, underinsured and uninsured patients.

Demand for the drug has fallen since last year. In 2022, patients were given around 7 million courses of the drug, according to U.S. government data. Through Oct. 1, around 3.4 million courses had been administered in 2023.

The new list price was first reported by the Wall Street Journal. 

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