Barriers to Worldwide Access for Paxlovid, a New Treatment for COVID-19. (7th April 2022)

• Record Type: Journal Article
• Authors: Pepperrell, Toby; Ellis, Leah; Wang, Junzheng; Hill, Andrew
• Is Part Of: Open forum infectious diseases. Volume 9:Number 9(2022)
• Publication Date: 2022-04-07
• Subjects: access to medicine -- biosimilars -- COVID-19 -- Paxlovid -- test-and-treat; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac174
• Languages: English
• ISSNs: 2328-8957

Abstract

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.