People who buy the most medicines in COVID-19.

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Behind the rush to buy antiviral drugs in COVID-19

Special contributor of this newspaper Yuan Lu Intern Zhao Jiaxin

2023-0 1-07 19:24

Source: Newspaper.

From the moment when he decided to buy paciclovir (nimativir/ritonavir tablets), robing focused on brushing the drug purchase platform every day, "doing nothing else". Her idea is to prepare one or two boxes of COVID-19 antiviral drugs for the elderly who may have high-risk diseases at home.

After two days of "fighting", she grabbed a box and shared her snapping experience on social platforms.

She soon received a private letter asking for medicine. The other person is in Australia. He bought this medicine at a cost of 18500, but the medicine could not reach Changsha the day after tomorrow. His elderly parents were infected with COVID-19 in Changsha and needed to borrow it from robing.

Paxlovid snapped up by robing was developed in Pfizer, USA. In February, 2022, Paxlovid was approved for import registration by the State Administration of Medical Products, and then it was written into the ninth edition of COVID-19 Diagnosis and Treatment Plan as an antiviral drug.

At present, only some hospitals in China have Paxlovid, and the online sales channels and quantity are limited, so it is hard to find a medicine. Lu Hongzhou, president of Shenzhen Third People's Hospital, told this reporter that in order to avoid the development of serious diseases such as respiratory failure and multiple organ failure, patients should use antiviral drugs at the first time, and the best time for the elderly and patients with basic diseases is in the first week after infection.

However, at present, the elderly or basic patients infected with COVID-19 are in urgent need of medication and may not be able to buy it at the best time of taking it; If the medicine is prepared in advance, on the one hand, there is no professional medical staff to check the medication, on the other hand, it will inevitably lead to a run on resources, and it is even more difficult for "dangerous" elderly people in remote areas who urgently need medication to buy medicine.

In response to these phenomena, Jiang, an epidemiologist and professor at Fudan University School of Public Health, said in an interview with the newspaper that on the one hand, we should severely crack down on drug price fraud and black market trading. On the other hand, if there is a shortage of medicines, the supply situation should be improved. It is suggested that the government should actively negotiate with Pfizer on the price and supply of drugs, and do a good job in statistics and supervision to ensure that people who really need drugs can use them in time.

The price of the yellow cattle selling paciclovir.

Grab medicine

On February 28th, 65438, 35-year-old Fontaine woke up at 6: 00 in the morning and stood in front of the prescription page of paciclovir. As soon as 10 arrived, she started clicking the mouse. Suddenly the page shows "Address Out of Stock". She didn't give up and continued to refresh the prescription page. Subsequently, the news of the drug purchase group popped up at the top of her mobile phone screen, and everyone said that they did not grab it.

Fontaine still didn't quit, constantly refreshing the page. 10: 06, suddenly switch to the payment page. She can even hear her heartbeat clearly, click Pay carefully, enter the password, and the purchase is successful. She almost jumped up and quickly bought the pills and told the group that they could still pay, but when the group came back to buy them, they were completely out of stock.

On February 25th, 65438, Fontaine learned that some high-end private hospitals in Beijing could prescribe paciclovir. There are five 80-year-old people in her family, 1 tumor patients, who live in Jiangsu and Zhejiang provinces respectively, and all of them have been infected with COVID-19. She thinks that one box at a time is "the safest".

So on the evening of the 28th, she planned to buy another box on another platform. "It may be that there were fewer people who knew this channel at that time and fewer people got the prescription. The payment process is very smooth. "

Within one day, Fontaine "successfully packed" two boxes of paciclovir and sent them to her family in two places as soon as she received the medicine. She "finally got a stone in her heart."

She did her homework before deciding to buy: "The clinical trial results published by Pfizer show that if treated within 3 days after symptoms appear, this drug can reduce the risk of hospitalization or death of high-risk groups by 89%."

In fact, paciclovir is not a "magic medicine", and its application population and window period are limited. Its main function is to inhibit virus replication, reduce the development and deterioration of diseases, and be used for early intervention of severe and high-risk groups. The applicable population is adults and adolescents (12- 17 years old, weighing ≥ 40kg) who develop into severe and high-risk factors within 5 days.

Previously, Fontaine also learned about the prescription rules of second-and third-class hospitals and community hospitals in Beijing, and found that the prescriptions of the elderly in his family did not meet the requirements. "Because seriously ill elderly people need to be taken to the scene for medical treatment, it is possible to prescribe this medicine, and this medicine is only available in a few hospitals and cannot be prescribed to the elderly in other places."

Fontaine can only find another way. She joined a group of more than 300 people to buy medicines in advance, and the people in the group are in the same situation as her: there are relatives in the family who are old or have serious basic diseases, and everyone wants to prepare medicines for their relatives, share the process or experience of purchasing medicines with each other, and agree to send people to the drug sales platform to refresh every half hour to see if there is any replenishment. The platform is on sale every morning on 10, and people who buy medicine need to buy it on 10 with a prescription issued by the platform doctor.

On February 27th, 65438, Fontaine decided to prepare for the next day's drug rush. She began to consult the doctors on the platform frequently, hoping that a doctor would give her a prescription the next morning, but she was repeatedly rejected. It was not until the group friends reminded her that she needed to upload her family's basic medical records, hospitalization certificates, non-vaccination certificates and other materials to reach the drug threshold that she filled out her family's medical records one by one, and then the doctor was willing to try to prescribe for her.

Zhou, a doctor of genetics at the University of Alabama at Birmingham, suggested in the column "Intellectuals", "Can some domestic online platforms sell drugs and community hospitals train drugs to identify people who are not suitable for taking drugs, or deal with drug conflicts with other drugs? Some conflicting drugs need to be reduced, some need to stop taking drugs, when to resume taking drugs, and when to metabolize paciclovir in the body. "

True and false generic drugs

Robing is 37 years old and his father is 63 years old. He has chronic obstructive pulmonary disease and cirrhosis. Under normal circumstances, his blood oxygen is below 95, "between 90 and 95". Her grandmother is over 80 years old and has rheumatoid disease and heart disease.

Buying Paxlovid online made robing feel "hopeless". She turned her purchase direction to the Indian version of generic drugs. When she sees someone posting a purchase experience on a social platform, she will ask about the purchase channel. Finally, when she saw that someone bought too much and wanted to resell it, she immediately spent 1800 yuan to buy a box of medicine.

On 20211165438+6, Pfizer reached an agreement with MPP to allow generic drug manufacturers to supply their experimental antiviral oral drugs to 95 low-and middle-income countries, including India, so that patients in underdeveloped countries can buy cheap generic drugs.

During this period, the number of people looking for scalpers to buy medicine through various channels increased. Huahua claimed to buy Paxlovid from the United States and its generic drug from India. In the market, the regular price of 2,300 yuan of paciclovir was fired to13,000 yuan a box, and the generic drug was 4,000 yuan a box. Too many people ask her for medicine every day. "I am exhausted after finishing the list. If I don't hurry, I will be out of stock."

Huahua is from Chongqing. According to her observation, there are few buyers in southwest China, and there are many people buying medicine in Beijing and Shanghai. Huahua has received many urgent orders in the past few days. "In some areas, people wait for the death of the elderly at home and enter the ICU to start buying this medicine."

However, "online overseas purchasing of generic drugs bypasses the quality supervision of basic drug production, and there are huge security risks." Zhou wrote in the column.

After buying that box of generic drugs, robing saw that someone bought the same version of the medicine on the Internet. After identification, she found that the ingredients of this medicine are different from the genuine ones. This surprised Robin. He was afraid to give it to his family.

On February 28, 2022, at 65438, she returned to the platform to grab medicine. The same process as the day before, she stared nervously at the screen of her mobile phone, and her fingers flew faster. She really took a box. "I was almost crying at the time."

Later, someone left a message on the social platform telling her that she had robbed a box of extra medicine and happened to live in the same city. They made an appointment to get the medicine face to face, and robing gave each other 5000 yuan.

In addition to Pfizer's Paxlovid, robing also prepared a box of domestic azvudine, which was recommended by the doctor on the first day of her drug rush, and a box of 330 yuan.

With these medicines in his hand, Robin felt relieved. On those nights when she didn't buy medicine, she couldn't sleep at night and was preoccupied with how to buy medicine. No matter what the cost, she is willing to find someone.

In order to reassure her, she spent 300 yuan to send the drug samples she bought to a testing institution for testing. On June 2, 65438, the test results she received showed that there was no nematvir in the sample, which indicated that the generic drug she bought was fake.

Test results of generic drugs purchased in Beijing.

Paxlovid is an oral COVID-19 drug, which is composed of nemadevir (content 150mg/ tablet) and ritonavir (content 100mg/ tablet). Pfizer authorized imitation companies can imitate its raw materials or finished products of paciclovir.

At present, there are two Indian imitation Pfizer COVID-19 oral drugs, Primovir in green box and Paxista in blue box, which have entered the domestic market. Real generic drugs are drugs with the same active ingredients, dosage forms, routes of administration and therapeutic effects as the original drugs. The instructions of blue box and green box generic drugs show that the drug components are (nematevir, content 150mg/ tablet) and ritonavir (content 100mg/ tablet).

Primovir is Paxlovid produced by Strica Pharmaceuticals in India, which imitates Pfizer and has the same active ingredients.

Borrow medicine

Robing didn't want to buy Paxlovid at first. When she saw the price, she thought, "Who will buy this medicine?" . But when she knew that there was an old man beside her, because COVID-19 died, she decided to prepare this medicine.

Robing's father lives with her grandmother, and most people around her are infected, including herself and her five-year-old child. In order to protect the elderly at home, she has not been to her father and grandmother's house for nearly 20 days. "If one of them is infected, the other one will definitely not run away."

Robing's first thoughts are of her doctors, relatives and friends. Her uncle works in the Municipal Maternal and Child Health Hospital. He told robing that there were more than a dozen boxes of paroxetine in their hospital, and three boxes had been used, but these boxes could not be opened casually, and only three ICU directors in the hospital could open them. Then, she asked her friend who worked in the ICU of the 3A hospital. A friend told her that a batch of goods came to the hospital a few days ago, about a dozen or twenty boxes, which were robbed in one minute. There are six or seven ICU in this hospital, all of which are full. "There are many patients waiting for this medicine. In our second-tier cities, you can't buy hospital medicine. "

Robing began to brush social platforms crazily, and saw some people say that private hospitals in Beijing, Shanghai and Shenzhen can buy this medicine, and at the same time saw some people say that online shopping platforms can be robbed.

Many people seek medical treatment under robing's post these days. Robing hesitated when he received a private letter from the borrower. "This medicine is so tight now that I refuse to give it away. It's not about money, but I can't buy it either. " She is also worried that the person she meets is a scalper. She thinks that if the parents of the drug seeker are waiting for the medicine to save her life in the hospital, she is willing to send the medicine directly to the doctor in person and return it to her when the other party has the medicine.

But the parents of the drug seeker didn't go to the hospital. Robing predicted that the other party's situation was not so urgent, and he didn't want to lend his "hard" medicine. The drug seeker sent her another message saying that her father had cancer. I had chemotherapy for 8 times last year, and now I'm infected again. The symptoms are very serious. At the same time, she saw in his circle of friends that the other party was eager to ask for medicine everywhere and was willing to spend any money.

Robing told him that this medicine also has side effects, so we can monitor blood oxygen first. That night, the other party sent a message saying that mother's blood oxygen was not working, and it had dropped to 85.

Robing decided to lend him the medicine, and at 8 o'clock in the evening, the other party asked someone to pick it up at her door. After taking the medicine for a few hours, the old man's blood oxygen gradually returned to normal and there was no fever. But at midnight, I started to have a fever again. The next day, after taking the medicine for the second time, the old man's blood oxygen has stabilized at 92~96.

The drug seeker promised to return the medicine she bought to her immediately after receiving it.

take medicine

At the same time, Wang Jie in Neijiang, Sichuan is also in a hurry to buy medicine. Her grandfather is 85 years old and has basic diseases such as bronchitis, chronic obstructive pulmonary disease, coronary heart disease and hypotension. 65438, on February 22nd, 2022, the old man was infected with COVID-19. After several days of observation, the old man began to cough up blood. On the evening of February 28th, 65438, Wang Jie called 120 to take the old man to the hospital. Blood routine, electrocardiogram and CT examination were done in the hospital, and the results showed that COVID-19 had caused lung infection. I was hospitalized for four days. The main treatment was infusion, antibiotics and some cough medicine.

The doctor told her, "There is no hope, because there is no specific medicine. We can find a way to buy paciclovir from Pfizer. " Although mom has missed the best medication time for five days.

Before taking medicine for her mother, Wang Jie had asked the doctor about the contraindications on the Internet. Pacciclovir has 27 pages of packaging instructions, in which 25 drugs are forbidden to be used together, and it is mentioned that patients with liver and kidney damage need to adjust the dose or ban the use. For the elderly with basic diseases, it needs to be used under the guidance of a doctor.

Drug searchers on the internet

Recently, some community hospitals in Beijing and Shanghai began to release paciclovir, but the reality is that the supply of drugs is still limited, patients in urgent need can't wait for drugs, and community doctors dare not prescribe drugs rashly.

6543813, the staff of a community health service center in Huangpu District told this newspaper that dozens of people called Pfizer to ask about this medicine every day, but the center did not get this medicine. The specific time to get this medicine depends on the arrangement of the municipal government. The staff of Ma Lu Town Community Health Service Center in Jiading District told this newspaper that there is this medicine in the community at present, but the reserve is small, so it cannot be prescribed at will. You need to register on the spot and go to the fever clinic. The doctor will judge whether to prescribe medicine according to the condition.

On the same day, the newspaper contacted a number of community hospitals in Beijing to inquire about the adjustment. Several staff members indicated that the reserve was limited, and gave a series of prescription conditions that needed to be met: for example, they must be residents of the community, over 65 years old, have a single nucleic acid tube positive certificate, and have basic diseases, and can only prescribe drugs after being evaluated and audited by community doctors.

According to the People's Daily Dajiangdong Studio, many antiviral drugs have not yet reached vulnerable people with serious tendencies in time. Grass-roots doctors lack relevant training, some are worried about contraindications, while others are "I heard that this medicine is precious and unwilling to give up, in case there are heavier patients". Experts suggest that community doctors should be instructed to use drugs promptly and decisively to effectively prevent serious diseases.

The high price has also raised the threshold for drug use, and it is more difficult for people in urgent need in remote areas to get access to this antiviral drug. However, on June 5438+1October 5, the on-site negotiation on the adjustment of the national medical insurance drug list was started, including this paroxetine antiviral drug.

At the beginning of 2022,