Chinese health experts are warning that fake versions of Indian generic medicines are flooding the black market in China as a record surge of COVID-19 cases fuels demand for antivirals, particularly Pfizer’s Paxlovid and Indian generic versions.
With Paxlovid in short supply and highly regulated in government clinics, sales of Indian generic versions have ballooned through Chinese e-commerce platforms in the wake of the ending of the “zero-COVID” policy on December 7.
China has seen millions of cases since then — an estimate of the National Health Commission pegged the figure at 250 million as of December 20 — and although most have been mild, cities have seen a high number of deaths particularly among unvaccinated elderly. Crematoria in many Chinese cities have reported record waiting periods.
With the huge demand for COVID-19 medication, some fake versions of Indian generics have also entered the market.
“Chinese laboratories are raising the alarm over a new potential danger to public health amid a massive wave of COVID-19 infections: a growing trade in fake antiviral medication,” Chinese media outlet Sixth Tone reported.
“Boxes of Paxlovid are now selling for as much as 50,000 yuan ($7,200) on the black market, forcing many in China to seek out cheaper alternatives. That is driving a surge in demand for generic versions of the drug produced by Indian manufacturers. However, laboratory analysis indicates that a large amount of the ‘Indian drugs’ circulating in China are fake,” the report said.
While there has been no evidence of the fake versions causing harm so far, experts are concerned as they are ineffective against the virus and could end up resulting in patients not seeking treatment.
Paxlovid has been made available through government clinics, but has been in limited supply. Sales are also highly regulated with doctors evaluating patients’ need for the drug and largely limiting it to senior citizens.
As the Sixth Tone report noted, channels used previously to sell made-in-India cancer drugs are now offering antivirals.
“On the Chinese e-commerce platforms... at least four generic COVID drugs produced in India — Primovir, Paxista, Molnunat, and Molnatris — have been listed for sale in recent weeks. Primovir and Paxista are both generic versions of Paxlovid, while the other two are generic versions of Molnipiravir. All four drugs appear to have been approved for emergency use by the Indian authorities, but are not legal for use in China,” the report said.
Some Chinese who tested Primovir pills they had purchased found the drugs did not contain Nirmatrelvir, a key component.
Yin Ye, the head of BGI, a Chinese genomics company, wrote on December 31 that of 143 samples tested of what was sold as Primovir, only one contained Nirmatrelvir.
After China eased restrictions in 2019 on the import of drugs, unapproved medicines, including cancer drugs from India, have entered the country in large numbers, although the trade had been curtailed because of limited transport channels during the pandemic.
He Xiaobing, the head of Beijing Memorial Pharmaceutical, told Sixth Tone that India was “the only country where we can source reliable and affordable COVID drugs with guaranteed therapeutic effects”.
“But the strong demand was used by illegal groups who produce counterfeit drugs,” he added. “This will badly affect patients’ treatment.”