Chinese people are buying and selling painkillers and Covid-19 antiviral drugs through a thriving online black market, as hundreds of thousands of Omicron infections trigger a demand for antiviral and fever-reducing medicines. 

In early December, the Chinese government abruptly lifted its zero-Covid restrictions, leaving citizens scrambling to prepare for the country’s worst Covid-19 outbreak. With an under-vaccinated elderly population, and Covid-19 therapies in short supply, scalpers and residents with spare medicines have been selling the products online at a premium. 

A 50-year-old Chinese entrepreneur based in the U.S., who specializes in selling Indian generic drugs, told Rest of World he had spent almost all of his waking hours this past month handling orders from Chinese clients. Since December, he has sold about 20,000 boxes of the generics of Paxlovid as well as Merck’s molnupiravir through his Twitter account and a Telegram group. 

Paxlovid, the only foreign Covid-19 medicine approved in China, can be purchased for about $320 from hospitals or online clinics through prescriptions. But many people have reported difficulty in getting the drug through official channels, as residents across the country rush to stock up on medicines for their vulnerable family members. 

“I’m making good profits but also helping people,” said the U.S.-based seller, who requested anonymity because he was worried identifying himself would hamper his business. Before the Covid-19 surge, he mostly sold generic cancer drugs and drug ingredients to those who could not afford the original versions. “I’m helping the government solve its problem.” 

The businessman said he was in New Delhi this week, and had taken videos of a well-stocked pharmacy to share with his buyers. He said he had a profit margin of about 15% from selling Paxlovid generics, priced at between $145 and $203. Some customers have ordered 300 boxes in one go to resell in China, he told Rest of World

On Chinese social platforms, including Weibo, WeChat, and Xiaohongshu, traders sell Paxlovid for as high as $2,200, with some claiming they would ship from the U.S. In nearby regions like South Korea, Taiwan, and Hong Kong, pharmacies are running out of cold and flu medicines as people ship them to their contacts in China. 

A businessman in Shaanxi province, Zhang Junfei, told Rest of World he had sourced medicines from the more sparsely populated border regions of Tibet and Xinjiang, where demand was lower, and sold them to his contacts on WeChat. Zhang had sold some 400 boxes of Ibuprofen and about five boxes of Paxlovid — he declined to reveal where the antiviral drugs came from. His products also included Covid-19 testing kits and intravenous immunoglobulin, an antibody therapy that has not been proven to be effective against Covid-19.

The black market has prompted fabrications and scams. Yin Ye, chief executive of genomics company BGI Group, wrote on Weibo this week that he had tested some drugs packaged as Indian Paxlovid generics and found them to be counterfeits. One consumer told AFP the Paxlovid she had ordered through an online agent never arrived. 

Logistics could be another challenge, as international shipping and delivery services have been delayed due to many workers falling sick over the past month. Liu, a resident of Hunan province, who only gave his last name for privacy reasons, told Rest of World he had purchased five boxes of Paxlovid generics in December, but, by the time the parcel arrived in China 23 days later, his family members had all recovered. He said he planned to sell the drugs to others.

While the latest Covid-19 wave might have peaked in major cities across China, according to some researchers, rural areas would see cases continue to increase in the coming weeks. Last month, Tencent launched a program on WeChat to connect people who need medications with those nearby who have spare products. As late as Thursday this week, users, including those located in small towns and villages, were still pleading online for Ibuprofen pills, thermometers, and Covid-19 testing kits.