‘Best therapeutic choice’: WHO backs Pfizer’s COVID antiviral

UN health agency says Paxlovid ‘strongly recommended’ for patients with non-severe disease, but at risk of hospital admission.

The World Health Organisation (WHO) has given its backing to Pfizer’s Paxlovid treatment for COVID-19 after studies showed the antiviral pill reduced the risk of high-risk patients being admitted to hospital by 85 percent.

The WHO announced on Thursday it was making a “strong recommendation” for the use of Paxlovid – a combination of nirmatrelvir and ritonavir – for people with mild and moderate COVID-19 but at risk of hospital admission, calling it the “best therapeutic choice for high-risk patients to date”.

The new recommendation followed two trials involving nearly 3,100 patients that showed treatment with Paxlovid reduced the risk of hospitalisation by 85 percent, equivalent to a potential cut in hospital admissions in that group of 84 people per 1,000, it said.

Cases of COVID-19 continue to fall around the world, but the disease continues to take a toll on older people, those with pre-existing conditions such as heart disease and diabetes, and the unvaccinated. The WHO has been adding more drugs to its list of recommended treatments as the pandemic has progressed, backing arthritis drug baricitinib in January as the Omicron variant surged.

In recommending Paxlovid, the WHO expressed concern that low- and middle-income countries could struggle to source sufficient supplies of the drug.

“WHO is extremely concerned that – as occurred with COVID-19 vaccines – low- and middle-income countries will again be pushed to the end of the queue when it comes to accessing this treatment,” it said in a statement.

The agency noted a “lack of transparency in bilateral deals” made by Pfizer and that, while the US drugmaker had a licensing agreement with the Medicines Patents Pool, there were limits on the number of countries that would benefit from generic production of the drug.

In February,  Pfizer said it expected sales of the Paxlovid to reach $22bn in 2022.

“WHO strongly recommends that Pfizer make its pricing and deals more transparent and that it enlarge the geographical scope of its licence with the Medicines Patent Pool so that more generic manufacturers may start to produce the medicine and make it available faster at affordable prices,” it said.

Pills such as Paxlovid and molnupiravir, produced by rival Merck, have been seen as a huge step forward in COVID-19 treatment because patients can take them at home.

But the course of treatment also needs to begin in the early stages of the disease, creating another challenge for low- and middle-income countries whose testing rates are well below those of the developed world, the WHO added.

The UN agency also updated its guidance on remdesivir, which it previously advised against using.

Following a new study, WHO now suggests the drug be used in mildly or moderately ill patients at risk of hospitalisation. Remdesivir was developed by US pharmaceutical company Gilead Sciences for the treatment of Ebola.

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