Sign up for our special edition newsletter to get a daily update on the coronavirus pandemic.

A black market has emerged in Russia for an antiviral HIV drug being tested around the world as a possible treatment for COVID-19, according to a report.

After reports from China that Kaletra was beneficial against the illness caused by the coronavirus, the Russian Health Ministry recommended it as a possible treatment – but then cautioned that its effectiveness was uncertain, Reuters reported.

More than 20 trials are being conducted globally on Kaletra, which is produced as the generic Kalidavir in Russia, both as a treatment or post-exposure prophylaxis, the news outlet reported.

But speculators have jumped on the bandwagon amid fears that the drug might eventually be in short supply, according to Reuters, which interviewed sellers, HIV activists and the head of the drug’s main Russian producer.

“Three months ago, people were buying Kaletra from us without much enthusiasm for 900 rubles ($12) a box,” one online trader of HIV drugs told the outlet.

“Now, anticipating (supply) interruptions, people are buying between 100 and 700 boxes from us, at 3,800 rubles a box. Mainly, people are buying (Kaletra) with the aim of reselling it for a very high price,” the person said.

Resellers can get between 7,000 and 8,000 rubles — about $94 to $107 — per box, the trader said.

The prescription-only HIV medication is purchased in bulk by the Russian government and distributed for free to registered HIV patients, but many people replenish their stocks privately, from pharmacies, due to interruptions in supplies, according to Reuters.

The director of a St. Petersburg clinic that specializes in infectious diseases said his pharmacy had been flooded with calls from worried HIV patients.

“We have a van coming from the pharmaceutical company, and everything in it has already been claimed in orders,” the H-Clinic’s Andrei Skvortsov told Reuters. “There were up to 120 calls a day.”

His said his clinic’s supplies of the generic drug were stable, but that the distributor of Kaletra had told him the delivery would be the pharmacy’s last because of the need to redirect it for state tenders.

On Jan. 29, the Health Ministry instructed physicians to use Kaletra’s combined components lopinavir and ritonavir to treat COVID-19 based on studies of the treatment of other coronaviruses, including severe acute respiratory syndrome, or SARS.

Kaletra is produced in Russia by R-Pharm under a deal with the American drug maker and patent-holder AbbVie.

The Financial Times has reported that the company would not enforce its global patent rights on all formulations of the HIV medication.

One Russian HIV activist told Reuters that speculators were trying to buy Kaletra from HIV patients for 3,000 rubles ($40) a box.

The activist, who asked to be identified only by his first name, Alexei, runs a “back-up medicine cabinet” with a network of patients in 20 cities.

“Messages and calls started coming in from people saying they were ready to purchase these medicines,” Alexei told Reuters. “They are resellers and middlemen … They are ready to buy everything, down to the last box. We tell them to shove off.”

R-Pharm chief Alexei Repik said Kaletra has been seen for the first time being sold illegally in pharmacies without a prescription.

“It used not to feature at all, because … the medicine was previously only needed by HIV patients,” he told the outlet.

He added that R-Pharm helps police track the provenance of drugs being sold illegally because all black market sales leave patients stranded.

Kaletra’s most common side effects are stomach upset and nausea, but it also can lead to liver and cardiac rhythm problems, according to Repik, who did not expect shortages because R-Pharm was boosting production.

“But of course no one can predict the full scale of the epidemic,” he said.

The Russian Health Ministry did not respond to Reuters’ questions about the drug’s resale or possible shortages.