China-developed oral drug for COVID-19 treatment Azvudine

China's first domestically developed oral drug for COVID-19 treatment was removed from shelves of e-commerce platforms on Saturday, hours after media reported its online sale had started in some drugstores.

Experts and China's protocol for COVID-19 prevention and control suggested it is inappropriate for the medicine to be available to the public in drugstores as suspected and confirmed COVID-19 cases should be isolated and treated in designated healthcare facilities.

News first came on Saturday morning that some pharmacies had started online sale of Azvudine, produced by Chinese pharmaceutical firm Genuine Biotech. On some e-commerce platforms such as Meituan and Eleme, pre-sale links for Azvudine by these pharmacies could be found, with prices ranging from 350 yuan ($49.2) to 499 yuan.

An employee at an online pharmacy told the Global Times on Saturday that the medicine is for pre-sale only because they don't have the stock, which may arrive next week. And customers need to provide a doctor's prescription before placing an order.

However, all the pre-sale pages disappeared before Saturday noon after another Chinese media outlet reported that Genuine Biotech has communicated with relevant pharmacies over the online sale of Azvudine, which will be removed from shelves immediately.

In a later statement, Genuine Biotech explained that the online sale of Azvudine by some Shenzhen-based China Nepstar drugstores is an isolated case, with the original intention of meeting the needs of some people going to and coming from Hong Kong or overseas for anti-HIV-1 indication medicine.

The drugs for online sale is coming from the 10 bottles of Azvudine tablets procured by China Nepstar's Shenzhen branch, the statement said.

The company will strictly comply with the requirements of the national epidemic prevention policy and do a good job in the production and supply of anti-COVID-19 drug production under the coordination of the various ministries.

Moreover, the National Medical Products Administration has said Azvudine should not be allowed to sell to the public online or offline, domestic news site yicai.com reported, citing a source from China Nepstar Chain Drugstore, which was among the first to start the pre-sale of the medicine.

As COVID-19 is classified as a notifiable Category B infectious disease but regulated as a Category A infectious disease, suspected and confirmed cases should be isolated and treated in designated healthcare facilities, according to China's Protocol for Prevention and Control of COVID-19.

But if the drug is available to the public online, there is a possibility that it may be abused by the public as some people suspected of COVID-19 infection may try to fetch it via illegal ways to avoid getting hospitalization, which will violate the current epidemic prevention and control policy, Wang Guangfa, a respiratory expert at Peking University First Hospital, told the Global Times on Saturday.

In addition, the medicine has some side effects and could be dangerous for patients to take it at home without doctor's advice, Wang noted. Azvudine was originally approved to use for the treatment of people infected with the HIV-1 virus.

In July, China gave conditional approval for use of Azvudine to treat people with COVID-19. In August, Azvudine was included in China's 9th version national COVID-19 diagnosis and treatment scheme. About 40 percent of trial participants given Azvudine had improved symptoms within seven days, 30 percent higher than those in the placebo group, according to a Henan Daily report in July. It said the trials also found the drug could clear the virus in five days.

Another COVID-19 oral antiviral drug that has gained conditional approval from Chinese regulator so far is Pfizer's Paxlovid.