Talks between China’s insurance authority and pharmaceutical company Pfizer to include an antiviral medication in the public health insurance scheme have broken down. China’s National Health Security Administration said on Sunday that Pfizer’s Paxlovid oral medication , which is used to treat Covid-19, could not be included in the “register of drugs in the basic medical insurance”, because the company’s quotation was too high. Public insurance covers most of the cost of drugs on the register. China approved Paxlovid in February last year but the medication has not been widely available partly because of its high cost – around 2,300 yuan per pack. A temporary agreement with the administration brought that price to hospitals down to 1,890 yuan and inclusion in the register would have reduced it further to about 700 yuan, according to a report in the Economic Observer. Paxlovid will still be covered by public health insurance until March 31. Two other Covid-19 treatments, an antiviral called Azvudine by Genuine Biotech , and traditional Chinese medicine Qingfei Paidu, had been included in the list, the administration said. The authorities have tried to make Covid-19 drugs, including Paxlovid, more accessible to patients since China abandoned its zero-Covid policy and was confronted with a tsunami of infections. Paxlovid was nearly 90 per cent effective in preventing severe outcomes in elderly people in clinical trials, and was expected to be a major tool in China’s efforts to “prevent severe illness and deaths”. Small quantities of the drug were distributed to hospitals throughout the country, including community clinics. Demand is so great that batches were snapped up online just days away from expiry and people tried to source generic supplies from India . Reuters reported last week that China’s drug regulator, the National Medical Products Administration, had been leading talks with Pfizer since late last month to secure a licence that would allow domestic firms to make and distribute a generic version of Paxlovid. Covid-19 treatment has been free since the beginning of the pandemic, but from this weekend individuals will have to cover some of those costs. In guidelines released last week, each province has been asked to come up with their own plan but individuals must not pay for more than 30 per cent of the cost of the drugs. “The administration will issue a guideline on Covid-19 treatment drugs to guide enterprises to adopt a full-cycle, multilevel and transparent approach for reasonable pricing of Covid-19 antivirals,” the guidelines said. Five Chinese drug makers signed a deal with Pfizer last August to produce a generic version of Paxlovid for the United Nations-backed Medicines Patent Pool but the products are not allowed to be used in mainland China.