Is Mabaloxavir, the “miracle flu drug” that costs more than 300 yuan per box, really worth taking?

Recently, influenza has been prevalent in many places. According to the latest data from the China Centers for Disease Control and Prevention, the positive rate of influenza virus continues to rise, of which more than 99% are influenza A.

The H1N1 flu is coming with great force. In addition to the classic influenza drug oseltamivir, another drug "mabaloxavir" has also been out of stock.

According to China Economic Net, currently, some pharmacies are charging up to 300 yuan per box of Mabaloxavir. In response, the staff of the pharmacy said: "This drug sells very well, and many other places are out of stock, so it is sold at a high price."

E-commerce platform price

Red Star News reporters visited some pharmacies in Chengdu and found that the highest price of the drug has reached more than 450 yuan. Compared with the medical insurance payment price of 222.36 yuan per box of Mabaloxavir after the medical insurance negotiation, the price has doubled.

Mabaloxavir was included in the national medical insurance drug list only eight months after it was approved for marketing. The retail price was 498 yuan/(20 mg*2 tablets/box) before the medical insurance negotiations, and the medical insurance payment price after the medical insurance negotiations was 222.36 yuan/box, with a single tablet selling for more than 100 yuan.

1. Is Mabaloxavir really that effective?

"It only needs to be taken once for the entire course of the disease", "The fever goes down after one meal", "The symptoms are relieved quickly", the netizens' comments are becoming more and more miraculous, and Mabaloxavir has been dubbed the new generation of "magic influenza drug".

Mabaloxavir, also known as "Sufuda", works by inhibiting the activity of specific enzymes required for viral gene transcription, thereby inhibiting viral replication at the source and exerting its anti-influenza virus effect.

Compared with the traditional influenza drug oseltamivir, the biggest advantages of mabaloxavir are convenience and few side effects.

Generally, oseltamivir needs to be taken for 5 consecutive days, 2 tablets a day. However, mabaloxavir is a one-time medication, that is, patients only need to take it once within 48 hours after the onset of flu symptoms to relieve symptoms, which greatly improves the convenience and compliance of patients.

In terms of side effects, mabaloxavir usually has fewer adverse reactions, mainly including mild nausea, diarrhea, headache, etc., with no significant difference from the placebo group. The incidence of adverse reactions of nausea and vomiting caused is significantly lower than that of oseltamivir.

In terms of efficacy, both oseltamivir and mabaloxavir can be used to treat influenza A and influenza B infections. The results of the Phase III clinical study of mabaloxavir showed that the time for relieving influenza symptoms was comparable to that of oseltamivir, but mabaloxavir was more effective in treating influenza B, with the time for symptom improvement shortened by 27.1 hours compared with oseltamivir.

It is precisely for the above reasons that Mabaloxavir has become a more popular influenza drug than Oseltamivir.

2. When facing influenza, should you choose Mabaloxavir?

In fact, different groups of people have different choices.

Mabaloxavir is currently only approved for use in children aged 5 years and above and weighing more than 20 kg and adults. Oseltamivir capsules and granules are suitable for children aged 1 year and above and adults, while the dry suspension is suitable for even younger children, including newborns aged 14 days and above.

That is to say, if the patient is an adult, the symptoms are not particularly severe, and the onset time is within the "golden period" of medication, both drugs can be considered. If a young child has influenza, oseltamivir is more suitable because it has more experience in children.

In addition, due to the lack of clinical data, mabaloxavir is not currently recommended for pregnant and breastfeeding mothers, and oseltamivir is more recommended.

Mabaloxavir may be a good choice for those who are not convenient to take multiple medications or are sensitive to gastrointestinal reactions to drugs.

At present, oseltamivir has been included in the medical insurance catalog and included in the centralized procurement. The price is relatively low. If purchased in a hospital, some brands of oseltamivir may only cost 20 yuan, while the medical insurance negotiated price of mabaloxavir is 222.36 yuan per box. From an economic perspective, oseltamivir is also more suitable.

3. Can Mabaloxavir be used to prevent influenza?

Some people say that oseltamivir can be used to prevent influenza. Does that mean that taking mabaloxavir can also prevent influenza?

Currently, Mabaloxavir is approved for the treatment of influenza in China, but has not yet been approved for post-exposure prevention of influenza. Oseltamivir is approved for post-exposure prevention of influenza in people aged 12 years and above (taken continuously for 10 days).

Therefore, it is not recommended that you use mabaloxavir to prevent influenza on your own.

Finally, influenza A is a self-limiting disease, and patients with normal immune function can recover in about a week. However, for people with low immunity, such as the elderly, children, pregnant women, and people with underlying diseases, the risk of severe illness is greater after being infected with influenza A. Therefore, whether it is oseltamivir or mabaloxavir, it is recommended to take it within the "golden self-help time" of 48 hours after the onset of influenza. The earlier the medication is taken, the better the effect. If the onset exceeds 48 hours, taking the medication is still effective. In addition, the above drugs are all prescription drugs and should be used under the guidance of a doctor. Therefore, even if influenza A is confirmed, it is not recommended that patients blindly take the medication themselves.

References

1. Is the "miracle flu drug" Mabaloxavir really that effective? Visited 7 pharmacies, only 1 had stock. Doctor: Pregnant women are not recommended to use it

https://www.163.com/dy/article/JL8KR3GJ051492T3.html

2. More than 99% of cases are influenza A! What is the difference between oseltamivir and mabaloxavir? How to use them?

https://www.163.com/dy/article/JL73E0JH0514R9OJ.html

3. Hayden FG, Sugaya N, Hirotsu N, et al. Baloxavir Marboxil for Uncomplicated Influenza in Adults and Adolescents[J]． N Engl J Med, 2018, 379(10): 913-923.

4. Ison MG, Portsmouth S, Yoshida Y, et al. Early treatment with baloxavir marboxil in high-risk adolescent and adult outpatients with uncomplicated influenza (CAPSTONE-2): a randomized, placebocontrolled, phase 3 trial[J]. Lancet Infect Dis, 2020, 20 (10): 1204-1214．