Open Forum Infect Dis . Barriers to Worldwide Access for Paxlovid, a New Treatment for COVID-19

[tetano]

Open Forum Infect Dis


. 2022 Apr 7;9(9):ofac174.
doi: 10.1093/ofid/ofac174. eCollection 2022 Sep.
Barriers to Worldwide Access for Paxlovid, a New Treatment for COVID-19


Toby Pepperrell ¹ , Leah Ellis ² , Junzheng Wang ² , Andrew Hill ³



Affiliations

• PMID: 36176569
• PMCID: PMC9383702
• DOI: 10.1093/ofid/ofac174

Free PMC article

Abstract

Pfizer and the Medicines Patent Pool (MPP) have reached a voluntary licensing agreement for Paxlovid (nirmatrelvir+ritonavir), a novel antiviral for coronavirus disease 2019 (COVID-19) taken orally in the first 5 days from symptom onset. The Pfizer-MPP deal enables 95 low- and middle-income countries (L/MICs) to access affordable biosimilars. Generics are delayed awaiting bioequivalence testing and may be ineffective in L/MICs with reduced testing capacity, which comprise only 10% of global diagnoses. Thirty-nine percent of diagnoses originate in MICs forced to pay high prices due to exclusion from the Pfizer-MPP deal. The cost-effectiveness of Paxlovid could be limited compared with the creation of sustainable vaccine infrastructure in these nations, delaying socioeconomic pandemic recovery. Furthermore, Paxlovid may not be cost-effective in vaccinated populations, and concerns remain over ritonavir drug interactions with COVID-19 comorbidity medications. We call for expanded coverage by the Paxlovid-MPP deal and greater access to testing.

Keywords: COVID-19; Paxlovid; access to medicine; biosimilars; test-and-treat.