The lack of availability of a crucial COVID-19 drug has fostered a black market in China, as the country battles its worst coronavirus outbreak following the abrupt relaxation of stringent virus control measures earlier this month.

With a severe shortage of approved antivirals such as Paxlovid, which is manufactured by American pharmaceutical giant Pfizer, Chinese residents have resorted to underground channels to source the drug and various generic medicines, domestic media reported. Scalpers have reportedly been charging as much as 50,000 yuan ($7,170) for a box of Paxlovid — over 20 times its original price of 2,300 yuan — that would be enough for one course of treatment, while generic versions of the medicine sell for around 1,800 yuan.

China approved the use of Paxlovid in February for treating adults who have mild to moderate COVID-19 symptoms and a high risk of progressing to a severe condition. It remains the only legally imported medicine for treating the disease, though other generic ones under the brands of Primovir, Paxista, Molnunat, and Molnatris prevail on the black market given Paxlovid’s limited supply and expensive price.

Shanghai resident Sun Jianwei told Sixth Tone that he was considering asking his Hong Kong-based friend to buy a generic version of the drug, which is made in India. He said he had failed to purchase Paxlovid through legal channels.

“I want to buy some in case my parents get infected,” he said.

As COVID explodes in China, the country is struggling to ensure an ample supply of common medicines used to treat colds and fevers, though authorities have urged pharmacies to sell medicines in smaller packages so more patients can get them. Amid the grim situation, some people, including activist artist Nut Brother, are crowdsourcing medicines for vulnerable rural residents, while tech giant Tencent has developed a mini-app where people can offer and receive extra drugs or other health equipment.

Online, many social media users have criticized the scalpers for pushing up drug prices at such a critical time. A related hashtag translating to “scalpers selling Pfizer’s COVID medicine for 50,000 yuan” had been viewed 5.8 million times as of Wednesday afternoon.

“This scalper is selling Paxlovid for 19,000 yuan and has the guts to describe himself as a saint. May God punish those making a fortune from a national crisis,” one user with the name Yvonne commented on a Weibo post, which has screenshots of a scalper providing details about the medicine he has been selling.

Meanwhile, doctors have warned against rushing out to buy antivirals, which they say should only be taken under medical supervision to prevent potential side effects.

“Healthy young people with a good immune system can recover from current Omicron infections on their own,” Sha Kefu, a Beijing-based doctor, told Sixth Tone. “It’s not necessary for everyone to use Paxlovid — we only prescribe it to those who are seriously ill with obvious lung infections.”

Apart from the drug shortage, China’s healthcare system has been overstretched amid surging outbreaks across the country. Data from the National Health Commission showed that the country had 181,000 ICU beds as of December 25, or 12.8 beds for every 100,000 people, compared with higher-income countries like the United States and Germany which have 34.7 and 29.2 ICU beds, respectively, per 100,000 people.

Editor: Bibek Bhandari.

(Header image: Visuals from Irina Devaeva and Lesia_G/VectorStock/VCG, reedited by Sixth Tone)