Paxlovid’s prescription market uniquely volatile

Paxlovid posted KRW 79.4bn in prescriptions last year

Reimbursed from 2024… KRW 47.7 billion in Q3 alone

Sharp swings driven by COVID-19 case numbers: KRW 24.9 billion in September vs KRW 1.2 billion in December

The COVID-19 treatment ‘Paxlovid’ recorded approximately KRW 80 billion in outpatient prescriptions last year. With the 2024 National Health Insurance reimbursement decided, it caused a storm in the prescription market. Despite its high price, nearing KRW 1 million per course, it achieved massive prescription volumes. Driven by fluctuations in COVID-19 patient numbers, Paxlovid showed an unusual prescription pattern, with monthly sales differing by as much as 50-fold.

According to the pharmaceutical market research firm UBIST on the 20th, Paxlovid generated KRW 79.4 billion in outpatient prescription sales last year.

Paxlovid is an oral antiviral that suppresses replication of the COVID-19 virus and is primarily prescribed to high-risk patients at risk of progression to severe disease. In the early phase of its introduction in Korea, the government directly procured and distributed the drug free of charge. However, in June last year, the government halted new supply purchases, transitioning Paxlovid to routine prescribing in medical institutions. Starting October 2024, Paxlovid formally entered the prescription market after its National Health Insurance coverage was finalized. The reimbursement ceiling price was set at KRW 941,940 per course, with a patient co-insurance of 5%.

Monthly Paxlovid Outpatient Prescription Amount (Unit: million won, Source: UBIST)

Paxlovid made its full-scale market debut in Q4 of last year with KRW 4.1 billion in prescriptions. In Q2 this year, prescriptions exceeded KRW 10 billion, reaching KRW 11.4 billion. In Q3, sales surged more than fourfold quarter-on-quarter, reaching KRW 47.7 billion. At that time, total influenza drug prescriptions accounted for only 0.4% of Paxlovid’s volume.

Paxlovid showed fluctuating quarterly prescription sales last year. Sales rose 40% from KRW 8.2 billion in Q1 to KRW 11.4 billion in Q2, then soared to KRW 47.7 billion in Q3. However, Q4 sales plummeted to KRW 12.1 billion, just 25% of the previous quarter's level.

The high cost of Paxlovid, coupled with the rapidly fluctuating number of COVID-19 patients, led to significant fluctuations in prescription performance.

In the first half of last year, weekly COVID-19 hospitalizations remained relatively stable at around 100 patients per week. The peak was recorded in Week 13 (March 24–30) with 178 admissions, compared with a low of 56 patients in Week 5 (January 27–February 2).

Weekly COVID-19 Hospitalization in 2025 (Unit: Persons, Source: Korea Disease Control and Prevention Agency)

COVID-19 hospitalization counts are tallied based on patient numbers reported by 221 hospitals and higher-level medical institutions participating in the Acute Respiratory Infection Surveillance Program.

Hospitalizations began rising sharply in Week 31 (July 28–August 3) with 220 patients, and peaked in Week 37 (September 8–14) at 459 patients, triggering concerns of another major outbreak. However, from October onward, case numbers declined steadily, returning to first-half levels by November and December.

Monthly prescription data clearly reflects this trend. Paxlovid prescriptions rose from KRW 5.5 billion in July to KRW 17.4 billion in August, surpassing KRW 10 billion for the first time. In September, when COVID-19 hospitalizations peaked, monthly prescriptions reached KRW 24.9 billion, the highest among all pharmaceutical products. As hospitalizations declined, prescriptions dropped sharply to KRW 8.1 billion in October, followed by KRW 2.9 billion in November and just KRW 1.2 billion in December.