WHO 'strongly recommends' Paxlovid for treating Covid-19

The WHO on Friday strongly recommended the antiviral paxlovid from the American pharmaceutical group Pfizer for patients with less severe forms of Covid-19 and “at higher risk of hospitalization”.

But, similar to what happened with the Covid vaccines, the World Health Organization “is very concerned” that the less wealthy countries will once again have difficulty accessing this medication.

For WHO experts, the nirmatrelvir/ritonavir combination "is the drug of choice" for unvaccinated, elderly or immunocompromised patients, according to an article in the

.

For this same type of patients and symptoms, the WHO has also issued a “weak recommendation” for remdesivir from the American laboratory Gilead, which it had previously advised against.

The @WHO comes out strong in favor of Paxlovid for high-risk individuals in their new recommendations for Covid treatment @bmj_latest https://t.co/r2OVWh4v8o

Also updated on Remdesivir and other drug interactivehttps://t.co/FYhw0AsBpD pic .twitter.com/qXRvzhaYNl

— Eric Topol (@EricTopol) April 21, 2022

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Paxlovid would further reduce the number of hospitalizations

Paxlovid should be preferred over Merck's molnupiravir or remdesivir as well as monoclonal antibodies, says the organization, which continues to campaign for vaccination.

“It is crucial to prevent people from developing a serious form of the disease, from dying.

And vaccination is a key intervention for prevention,” insisted Dr. Janet Diaz, head of the clinical team in charge of the response to Covid-19 during a press briefing in Geneva.

Paxlovid "reduces the number of hospitalizations more than alternatives, has fewer potential risks than the antiviral molnupiravir, and is easier to administer than intravenous options such as remdesivir and antibody treatments".

Minimal positive effects in low-risk patients

The studies showed 84 fewer hospital admissions per 1,000 patients, no “significant difference in terms of mortality” and “little or no risk of complications leading to the cessation of treatment”, underlines the WHO.

This recommendation applies to people aged 18 or over and does not apply to pregnant and breastfeeding women.

It also does not apply to patients who are at low risk of complications because the positive effects are minimal.

The experts also declined to give an opinion regarding patients with a severe form of the disease due to lack of data.

The limits of antiviral treatments

However, the WHO emphasizes the limitations of these antiviral treatments.

In particular, they must be “administered as early as possible in the onset of the disease” which also implies access to tests to detect the infection and to a doctor to confirm the diagnosis and prescribe the drug.

Paxlovid must therefore be taken orally for five consecutive days and especially less than five days after the onset of symptoms.

In the case of remdesivir it is up to seven days after the onset of symptoms and it must be given intravenously over three days.

A barrier in low- and middle-income countries.

As for costs and availability, WHO calls on Pfizer to be more transparent and open.

According to Dr Lisa Hedman, who is in charge of access to medicines at the WHO, the American public radio NPR had revealed a cost of 530 dollars for a complete course of paxlovid in the United States, another source not confirmed by the WHO. reporting a price of around $250 in an upper-middle-income country.

For remdesivir, the cost per ampoule is 520 dollars, explained Lisa Hedman, but 53 to 64 dollars for those developed by generic companies in India.

Agreements for a less expensive generic version

In mid-April, Albert Bourla, CEO of Pfizer predicted a bright future for treatments like paxlovid because the disease is becoming endemic, but also because of a certain vaccine fatigue.

Accused, like its competitors, of having deprived the less wealthy countries of its anti-covid vaccine with RNA messenger to serve high-income countries, Pfizer has concluded licensing agreements under the aegis of the United Nations, making it possible to manufacture a generic version. cheaper than paxlovid.

But the WHO "strongly recommends" that Pfizer go further so that more generic companies can produce the drug.

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• Covid-19

• Coronavirus

• Health

• Pfizer-BioNTech

• Medication