Written By: Longjam Dineshwori | Updated : April 23, 2022 11:01 AM IST
Pfizer's Paxlovid consists of nirmatrelvir and ritonavir tablets.
The World Health Organisation (WHO) strongly recommends Pfizer's oral antiviral drug Paxlovid for mild and moderate COVID-19 patients at highest risk of hospital admission. In fact, the UN health agency called it the best COVID-19 therapy for high-risk patients to date.
To make this highly successful COVID-19 therapy easily available to low- and middle-income countries, the organisation is calling for wide geographical distribution and transparency from the originator company.
"Availability, lack of price transparency in bilateral deals made by the producer, and the need for prompt and accurate testing before administering it, are turning this life-saving medicine into a major challenge for low- and middle-income countries," reads a WHO statement.
Paxlovid is a combination of nirmatrelvir and ritonavir tablets. It is recommended for patients with non-severe COVID-19 who are at highest risk of developing severe disease and hospitalization, such as unvaccinated, older, or immunosuppressed patients.
Data from two randomized controlled trials involving 3078 patients showed that this treatment reduced the risk of hospitalization by 85 per cent.
However, WHO doesn't recommend its use in patients at lower risk, as the benefits were found to be negligible.
The medicine can only be administered while the disease is at its early stages and thus prompt and accurate testing is essential for a successful outcome with this therapy. This is one obstacle for low- and middle-income countries, where daily testing rate is low.
"Improving access to early testing and diagnosis in primary health care settings will be key for the global rollout of this treatment," WHO noted.
According to WHO, lack of transparency on the part of the originator company is making it difficult for public health organizations to obtain an accurate picture of the availability of the medicine, which countries are involved in bilateral deals and what they are paying.
Another obstacle is a licensing agreement between Pfizer and the Medicines Patent Pool that limits the number of countries that can benefit from generic production of the medicine.
The originator product, sold under the name Paxlovid, has been included in the WHO prequalification list. While several generic companies are in discussion with WHO Prequalification, it may take some time to comply with international standards so that they can supply the medicine internationally, the organisation stated.
Meanwhile, WHO wants Pfizer to make its pricing and deals more transparent and expand the geographical scope of its licence with the Medicines Patent Pool so that more generic manufacturers can start to produce the medicine and make it available faster at affordable prices.
The UN health agency has also updated its recommendation on remdesivir, another antiviral medicine.
Earlier, WHO had suggested against use of remdesivir in all COVID-19 patients regardless of disease severity, as the evidence at that time showed little or no effect on mortality.
Based on the new data from a clinical trial, WHO has now updated its recommendation on remdesivir, suggesting its use in mild or moderate COVID-19 patients who are at high risk of hospitalization.
However, it noted that the recommendation for use of the antiviral medicine in patients with severe or critical COVID-19 is currently under review.
