(Yicai Global) March 28 -- Chinese hospitals are making tough decisions, choosing who gets to use the world's first oral Covid-19 medicine approved by the United Sates' drug regulator amid new outbreaks.

"Given the insufficient production capacity of Paxlovid, our hospital only has 100 boxes," an expert at a Covid-19 treatment facility said to Yicai Global. "We must use it well to cure patients and not waste such a precious medical resource.” The city reported nearly 400 symptomatic cases as of March 25 so the available 100 boxes of drugs will not be enough for all.

The first batch of 21,200 boxes of Paxlovid arrived at Shanghai Pudong International Airport on March 17. Each box has 30 tablets of nirmatrelvir and ritonavir, a number big enough to complete a five-day treatment.

Last December, the US Food and Drug Administration granted emergency authorization to the American drug giant's antiviral therapy for Covid-19. Before that Pfizer agreed to supply the US government 10 million courses of treatment for USD5.3 billion, or USD530 per each. But the firm was also working toward expanding access in nearly 100 low and middle-income countries.

At least eight Chinese regions with new Covid-19 outbreaks, including Jilin and Guangdong province, as well as Shanghai, have received deliveries of Paxlovid. China reported more than 56,000 locally transmitted Covid-19 infections in the first 24 days of March, according to the National Health Commission.

"Pfizer’s oral Covid-19 drug came two days ago," said Lu Hongzhou, director of the Third People's Hospital of Shenzhen. The only hospital in the southern city designated for treating Covid-19 infections is still conducting clinical observation and needs to make systematic conclusions as the treatment cycle takes five days but the initial effects are noticeable, Lu added.

Hospitals are making decisions based on patients' backgrounds. "We give Paxlovid to people who are likely to develop severe infections, such as obese persons, the elderly, and those with chronic diseases such as cancer or diabetes,” said Lu. The hospital bought 1,000 Paxlovid boxes for CNY2,300 (USD361) apiece, a price lower than in the US.

Medicine importer China Meheco Group has the license to distribute Paxlovid in the Chinese mainland in 2022. Yicai Global called the firm to ask about further deliveries. "The import of Paxlovid is a commercial secret," said a person in the company's securities department. Pfizer China declined to comment on the matter.

Pfizer plans to produce 120 million courses of Paxlovid in 2022, depending on global demand, the firm said in a statement on its website last December. In the first half, it could make 30 million courses and accelerate production in the second half.

China also has a domestically developed remedy in the pipeline. Last December, the National Medical Products Administration announced it had granted emergency approval for a monoclonal antibody. The product is co-developed by Tsinghua University, the Third People's Hospital of Shenzhen, and Brii Biosciences. But the drug is not being sold yet, Yicai Global learned through several channels.

Editor: Emmi Laine, Xiao Yi