Impact of COVID-19 on Tofacitinib in Healthcare Industry
The first case of the COVID-19 pandemic was found in Wuhan, China. This pandemic has influenced the whole planet with its major impacts on the economy and businesses across the globe. The COVID-19 spread worldwide in unprecedented ways due to its high infectious and contagious nature and lack of availability of its vaccine. As a result, the greatest medical challenge in the 21st century is yet to face the healthcare sector worldwide.
Many European countries, along with the U.S. and Asia-Pacific, have been struck massively by the pandemic. The virus has spread across all regions ranging from the Middle East and Africa, Europe, Asia-Pacific, North America up to South America. The COVID-19 has been declared as a pandemic by WHO due to its increased spread across the globe. In order to limit its spread, numerous countries have declared the full lockdown, including the U.S., Germany, India, and China.
Tofacitinib, sold under the brand Xeljanz among others, is a well-known medication used to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. Ever since the emergence of the COVID-19 pandemic, people are searching for effective treatment to combat the virus and it’s harmful after effects. A new study in Brazil revealed that Janus kinase inhibitor tofacitinib reduces the risk of death and respiratory failure in hospitalized adults with COVID-19 pneumonia. However, the study is currently in progress, and previous trials that tested JAK inhibitors as therapies for COVID-19 have been mixed.
The main factors contributing to the growth of the global tofacitinib market are the surge in the geriatric population, rise in prevalence of rheumatoid arthritis, expiration of patents, and the entry of biosimilar drugs, among others. However, side effects related to the medication and high costs of biological DMARD therapies are expected to act as the key restraints of the global market.

IMPACT ON DEMAND
Coronavirus is an infectious disease caused by a SARS-CoV-2 virus, while a large population is affected by this COVID-19 virus. Coronavirus disease causes acute respiratory illness ranges from mild to severe pneumonia with respiratory failure. In order to minimize the spread of COVID-19, nearly all the countries have taken initiative action by locked down and social distancing restrictions.
COVID-19 is expected to be an opportunity for the tofacitinib market, showing mortality benefits in patients with COVID-19 pneumonia.
For Instance-
• In July 2021, in compliance with the Centers for Disease Control recommendations, the New England Journal of Medicine researched the impact of tofacitinib in COVID-19. The study's findings concluded that tofacitinib, when added to standard care, including glucocorticoids, led to a lower risk of clinical events among patients hospitalized with COVID-19 pneumonia than placebo.
This suggests that the increasing prevalence of COVID-19 poses a life-threatening challenge and enhances the demand for tofacitinib. This thus signifies that COVID-19 is accelerating the demand of the market.
IMPACT ON PRICE
Each tablet of XELJANZ contains 5 mg of tofacitinib, which is equivalent to 8.08 mg tofacitinib. The price of a 56-tablet pack of 5 mg tofacitinib is USD 88,323. On average, the cost per patient for the first six months is estimated at USD 518,400 based on the company's list price.
Due to the pandemic, the market is disturbed to a very high level. The several institutions have to remain shut while others scale down or put on clasp expansion plans as they tried to survive the unprecedented crisis. The uncertain past months have resulted in a downfall in sales of some company’s while others managed to stay afloat.
For instance-
• According to the annual report of Pfizer, Inc., the sale of its products increased from USD 41,172 million in 2019 to USD 41,908 million in 2020 amid COVID-19
• The company reported global revenue of USD 2,437 for XELJANZ in the financial year 2020. The revenue has increased by 9% from the reported 2019 global revenue for XELJANZ
The price of tofacitinib has seen an upward trend due to its rising importance in treating patients with COVID-19 pneumonia. Still, people opt for online consultancy, so there is a high demand for tofacitinib in some countries. Still, the restrictions imposed on borders of different countries and lack of tofacitinib will lead to a hike in prices in nearby future.

IMPACT ON SUPPLY CHAIN
The COVID-19 pandemic has transformed many organizations’ business environments; supply availability has been hampered by several issues, including export and travel restrictions by some producing countries and lockdowns that have forced suppliers to (temporarily) shut down.
The outbreak has disrupted the supply chains for drug manufacturers, including tofacitinib, due to the government-mandated mass quarantine. The unexpected outbreak affects commerce, and movement controls have culminated in the closure of a significant portion of the global economy, resulting in the disruption of supply chains due to insufficient materials and labor and the stagnation or stoppage production. In addition, many pharmaceutical firms give importance to the manufacturer of products that are essential for COVID-19.
The trade restrictions have left no choice but to make domestic manufacturing of essential drugs a necessity. During the pandemic, as the demand increases, counterfeiting of medicinal products is expected to increase.
To minimize supply chain crises, healthcare organizations have been firmly monitoring the supply chain with the assumption that the COVID-19 outbreak may adversely impact the supply chain of drugs, including shortages of tofacitinib or potential disruptions in its supply chains.
To manage such a crucial situation, many organizations are looking forward to improving and diversify supply chain models in all aspects. A diversified supply chain model is anticipated to minimize the export of drugs and increase end-to-end visibility. The resulting COVID-19 pandemic has shown the various ways for supply chain management, which may be effective within a remote working environment.

STRATEGIC INITIATIVES BY KEY PLAYERS
Companies in pharmaceutical are overseeing sales of drugs products will be careful in the pandemic and will not make bold moves in uncertain times. The strategic decisions taken during the COVID-19 outbreak will immensely vary from the pre-lockdown environment. In the coming months, manufacturers of non-critical drugs and devices and their suppliers are expected to face challenges due to the international policies on COVID-19.
Following strategic decisions or improvements have been made by manufacturers, governments, and related companies for improvement in processes, distribution, and revenue during COVID-19:
• Pfizer, Inc., an American multinational pharmaceutical and biotechnology corporation, announced the “Breakthrough Growth Initiative” to support innovation in the Pandemic type
• According to March 2020 article, the Pfizer, Inc. company outlined a five-point plan to battle COVID-19
• Usage available or historical data to predict risks involved and be ready to face the challenges that might be encountered further, mainly focusing not only on the negative but also identifying the possible positive risks and work on them accordingly

CONCLUSION
The COVID-19 has restricted the tofacitinib supply chain due to lockdown and quarantine policies. The demand for the tofacitinib has seen a surge in demand due to the pandemic. The increasing cases of rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis, among others, have boosted the market.
Different companies involved in manufacturing tofacitinib are discovering their way to deal with this pandemic situation. The government and companies around the globe are working in conjunction. They have advised those undergoing treatment for severe conditions during these unrivaled times during COVID-19 lockdown worldwide.
However, in the crisis call pharmaceuticals, key players, government bodies, and healthcare organizations work firmly with healthcare professionals, customers, and patients to better public health. Thus, it is sensible to assume that constraints on gathering and corresponding movements have impacted people who use tofacitinib.
However, healthcare industries and government bodies are exclusively focusing on making the effective and best contribution to control the spread of the virus and save lives. They are also boosting the production of essential medicines to new levels and ensure that the speed does not affect or destroy the quality of products.