Slow rollout of COVID antivirals delays 'game-changing' impact

Jan. 14, 2022

The rollout of two new COVID-19 antivirals that were intended to lessen the impact of the illness on hospitals and patients remains slow as drugmakers ramp up production.

Pfizer’s Paxlovid and Merck’s molnupiravir were both granted emergency approval from the U.S. FDA in late 2021, after studies found that the drugs reduced the risk of hospitalization or death due to COVID-19 when given to patients shortly after symptoms appear.

Since December, the U.S. government has only sent states enough Pfizer antivirals to treat 164,000 people. Unlike with COVID-19 vaccines, the U.S. did not make mass advance purchases, and lengthy production processes have made the rollout process longer.

Last November, the Biden administration secured 10 million courses of Pfizer’s antiviral for $5.295 billion. Last week, Pfizer announced that the U.S. government had committed to purchasing an additional 10 million treatment courses of Paxlovid. In comparison, the administration ordered 100 million doses of the Pfizer and Moderna vaccines prior to their launch.

According to Pfizer, the first 10 million Paxlovid treatment courses have been accelerated for delivery by the end of June 2022, with the remaining 10 million to follow by the end of September.

The manufacturing of Paxlovid can take 6-8 months. Paxlovid, the preferred option for treatment, is considered more effective and has fewer risks of side effects than Merck’s molnupiravir. Although molnupiravir can be manufactured in 5-6 months, the drug carries risks including the potential for birth defects when taken by pregnant women and is shown to be less effective than Pfizer’s antiviral.

States are choosing to distribute the pills differently with some, like Pennsylvania, choosing to focus shipments on the hardest hit areas and others distributing the pills more evenly across counties. All states, however, are unsatisfied with the amount of treatments they have received, especially given the explosion of COVID-19 cases due to the omicron variant.

“We need more of these drugs in order to make them alter the course of the pandemic and reduce hospitalization,” said Dr. Mary Bassett, New York State Health Commissioner.

State guidelines recommend doctors give priority to those at the highest risk, including patients, transplant recipients and people who have lung disease and are pregnant.