At the beginning of the year, many hopes were pinned on the corona drug Paxlovid.

The newly developed tablets from the pharmaceutical company Pfizer were conditionally approved in the EU in the fight against the virus.

Taken at an early stage after an infection, they should prevent severe disease progression.

Federal Minister of Health Karl Lauterbach (SPD) described the drug as "extremely promising".

However, the big promise has not yet materialized.

Not because Paxlovid isn't effective.

Rather, because it is rarely prescribed.

Thiemo Heeg

Editor in Business.

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It's hardly the quantity.

The tablets are more than sufficiently available in Germany.

The federal government ordered a million doses shortly after approval.

Of these, only 460,000 have been delivered to pharmaceutical wholesalers.

280,000 units threaten to expire by February 2023.

According to the Federal Ministry of Health, pharmacies have only received 64,000 units so far.

Doctors are reluctant

As great as the interest of patients in the antiviral drug is, doctors are reluctant to use it.

This has to do with the considerable amount of time involved in prescribing Paxlovid.

Because the medicine, which is intended to prevent severe corona courses with a probability of around 90 percent by inhibiting protein-splitting enzymes and thus preventing the virus from multiplying, must not be administered together with many common drugs because there is a risk of interaction.

However, many of these drugs, such as for high blood pressure, are being taken by people who are eligible for treatment with Paxlovid: the elderly with multiple health risk factors.

Doctors therefore rate the need for advice as enormous.

A doctor from Wiesbaden recently calculated that he had to explain to a corona-positive patient for 45 minutes which of his medications would have to be suspended for a few days in favor of Paxlovid or replaced by others.

This can hardly be done during normal consultation hours, and the patients are not always in the condition to understand such serious changes in the medication plan.

In the few cases in which he decided to use the drug despite all his concerns, the patient's state of health improved quickly, the family doctor confirmed.

Joe Biden and the "Rebound"

In addition to these organizational problems with the Pfizer drug, recent reports of cases in which treated patients suffered a relapse have caused uncertainty: negative tests and recoveries were followed by positive tests and symptoms again.

Experts speak of the rebound effect.

The most prominent example this summer was US President Joe Biden.

However, according to US data, hospital admissions and emergency room visits are rare in such cases, and rebound is not unique to Paxlovid treatment.

The bottom line is that experts like Torsten Feldt, senior physician at the Düsseldorf University Hospital, are critical of the reluctance to use Paxlovid.

The tablets are generally well tolerated and safe if the guidelines are followed.

If the indication is made correctly, the benefit clearly outweighs the risk.

"For me, the reluctance to prescribe Paxlovid, which is evidently widespread in Germany, is not justified."

In fact, the Federal Government’s Corona Expert Council attaches great importance to antiviral therapies in the treatment of Covid-19.

The researchers recommend optimized communication about the possibilities and limitations of Paxlovid and the planning of further studies, including dose adjustments.

Doctors' practices, hospitals and inpatient care facilities have recently been allowed to purchase and keep several packs of Paxlovid through their regular reference pharmacy.

In this way, the tablets should reach the patient more quickly and easily.

Older people benefit from the tablet

For Stefan Kluge, Director of the Clinic for Intensive Care Medicine at the University Hospital Hamburg-Eppendorf, the conclusion is: "People over the age of 65 or with an incomplete corona vaccination series or with serious previous illnesses benefit from Paxlovid even in Omicron times." significantly more effective than the alternative molnupiravir.

However, it does not have to be propagated for younger people without an immune deficiency and those who have been fully vaccinated.

"There shouldn't be any pressure to use it against the background of buying too many cans," warns Kluge.

He is in charge of the medical guideline with recommendations for inpatient treatment of Covid 19 patients, the new version of which was published on Monday.