From Thursday (September 1), COVID-19 patients can buy prescription antiviral medicines from pharmacies, as authorities ease access to weapons against the virus.

“Health agencies are offering easier access to these medications while still guarding the safety of patients,” said Dr. Udom Kachintorn, chair of Thailand’s committee on public health reform.

Pharmacists will be able to fill prescriptions for Favipiravir, Molnupiravir, and Paxlovid. Pharmacies are required to purchase these drugs from importers certified by the Food and Drug Administration (FDA) and record all sales to customers. The records will be monitored by authorities just like steroid sales.

Licensed suppliers can sell antiviral medicines to hospitals, clinics, and pharmacies in line with the regulations. Prices will not be controlled as the government believes market competition will ensure fairness and affordability.

Use with caution

FDA secretary-general Dr. Paisarn Dunkum said that although the Center for COVID-19 Situation Administration (CCSA) has permitted the public to purchase antiviral medicines from September 1, they should understand that not everybody requires them.

“You can only take them if they have been prescribed to you by a doctor,” Paisarn said. “So, if you don’t have a prescription, pharmacies will not sell antiviral medicines to you.”

Public Health Ministry permanent-secretary Dr Kiattibhoom Vongrachit added that antiviral medicines should not be stored in household medicine boxes as they have side effects and expiry dates.

“Like antibiotics, they should not be taken lightly or stocked,” he said.

The side effects of Favipiravir, for instance, include diarrhea, hyperuricemia (elevated uric acid), neutropenia (low white-blood-cell count), nausea, vomiting, and abdominal pain. Molnupiravir, meanwhile, may cause dizziness, headache, hives, itching, skin rash, nausea, redness of the skin, and vomiting. Paxlovid can cause changes in taste, diarrhea, high blood pressure, or muscle pain.

The drugs come with other precautions as well. For instance, Molnupiravir cannot be used on patients under the age of 18.

Meanwhile, most people who contract COVID-19 can recover with just basic medicines for fever and decongestion.

Beware of black-market drugs

Limited access to antiviral medicines has seen demand grow in the black market over the past couple of years. There is online chatter about how these antiviral medicines can be acquired via outlets that bypass official channels.

One online advertisement offered boxes of 40 200-milligram Molnupiravir tablets under the brand “Moluzen-200” for 4,590 baht apiece including delivery. Meanwhile, a course of the generic Indian version of Paxlovid can be bought for 9,900 baht.

Such offers tempt people into thinking they can keep these pills handy in case someone in their family catches COVID-19 and does not want to visit a doctor.

However, the Public Health Ministry joined hands with the Consumer Police Protection Division this month to crack down on a gang selling antiviral pills. The authorities seized a cache of contraband pills with a street value of about 10 million baht.

“They were smuggled into Thailand without a quality check or review by the FDA,” Public Health Minister Anutin Charnvirakul said. “How can you trust these medicines?”

He added that the haul of smuggled drugs will be destroyed to protect people who may be tempted to buy them.

The FDA said if convicted by the court, smugglers face up to five years in jail and a maximum fine of 10,000 baht for selling medicines without a license. They also face up to three years in jail and/or a maximum fine of 5,000 baht for selling unregistered medicines.

Meanwhile, health authorities insist they have arranged for an adequate supply of antiviral medicines during the country’s ongoing COVID-19 battle.

In the first seven months of this year (January-July), 265.5 million tablets of Favipiravir, 12 million tablets of Molnupiravir, and 275,210 vials of Remdisivir have been distributed for COVID-19 treatment.

And now that these medicines can be stocked by private hospitals, clinics and pharmacies, there is no need for people to take risks with smuggled antivirals, says the government.