Over the past three months, the cost of Russian analogues of favipiravir, a drug for COVID-19 with unproven efficacy, has halved, but not every Russian family can pay 11 thousand rubles per package. What factors will affect the further pricing of Russian drugs for coronavirus?
Expensive and doubtful
We are talking about drugs based on the active substance favipiravir, which still raises many questions from the scientific community. Studies that have studied its effectiveness have a number of drawbacks, so there is no unequivocal opinion about the acceptability of its use. Favipiravir has also been reported to cause serious side effects - nonspecific motor disorders. Studies in animal models have revealed its teratogenic effect, therefore preparations based on favipiravir are categorically contraindicated for pregnant women and people planning to become pregnant.
According to RBC, the first contract for the supply of a drug based on favipiravir, Avifavir, produced by the RDIF and Khimrar joint venture Kromis, was signed in early June. Until the end of the month, its average price in government purchases was 22.3 thousand rubles per package - an unaffordable price tag for an average family. In July, two more Russian drugs based on favipiravir appeared: Coronavir by R-Pharm and Areplevir by Promomed. This led to a decrease in the average price of supplies to 18.3 thousand rubles.
In September, the companies "Promomed" and "R-Pharm" received permanent registration certificates for their drugs and the ability to supply them at retail. "Promomed" left approximately the same price, which was formed in state purchases - 12 320 rubles, while "R-Pharm" reduced the cost from 15 400 rubles per package in state purchases to 11 550 rubles.
And although Roszdravnadzor believes that the gradual decrease in the cost of drugs is associated with increased competition in the market, the Federal Antimonopoly Service probably played an important role in this, which in September became interested in the validity of these prices.
According to Nikolay Bespalov, Development Director of the analytical company RNC Pharma, it is not worth relying on the fact that the cost of drugs will continue to decline significantly.
“This decline is very conditional, the first lots were shipped to the state segment at price tags that were very far from market realities. The price tag that is now really formed already due to a certain competition and the use of market instruments. So it is the current price level that should be considered the starting point, ”Bespalov said.
The expert noted that further reduction will occur due to the deepening of production and admission to the market of foreign generics, including Indian ones. But now it's too early to talk about a significant reduction in cost.
Vital and still inaccessible
On the eve of the Minister of Health Mikhail Murashko announced that favipiravir was included in the list of vital drugs (VED), which is used for state regulation of drug prices. In addition, medicines from this list are available for some categories of patients free of charge or at a reduced price. According to the doctor of clinical pharmacology of the Chekhov regional hospital Andrei Kondrakhin, the inclusion of drugs in the VED list insures the end consumer against unreasonable markups from suppliers and fakes. Thus, there is a guarantee that these drugs will at least not rise in price.
How profitable is the inclusion of drugs based on favipiravr in the list of vital drugs for manufacturing companies is a controversial issue. According to Nikolai Bespalov, much depends on the segment in which sales are planned. If in retail, then this is rather a minus for the manufacturer.
“But in general, given the fact that the drug has not been fully researched, it has nothing to do in retail, especially on the wave of excitement and taking into account the already known side effects,” the expert said.
Favipiravir versus remdesivir
Today it became known that two more drugs for coronavirus are registered in Russia: the antiviral drug remdesivir of foreign and Russian production.
“Now we do not have two antiviral agents for COVID-19, and remdesivir has a better evidence base. Recent studies have shown a pronounced bias towards efficiency, while I have not yet been able to see a similar publication on favipiravir. There was only a strange Russian study that raises a lot of design questions, ”medical blogger, physician Alexei Vodovozov told MedPortal. In his opinion, the appearance on the market of a well-known drug for coronavirus could potentially affect the cost of the Russian analogue of favipiravir.
Nikolay Bespalov believes that this is unlikely: the cost of remdesivir will be several times more expensive than favipiravir, since it is protected by a patent, and generic manufacturers still need to somehow agree with the copyright holder. Favipiravir does not face any competition yet.