US pharmaceutical giant Pfizer has signed a voluntary licensing agreement that should allow its coronavirus pill to be released beyond rich countries, Pfizer and the Medicines Patent Pool (MPP) jointly announced. , created by Unitaid, this Tuesday.

This agreement could potentially make it possible to add a means of combating Covid-19 to a still limited range.

A drug that is 89% effective

Generic drug makers "who are sublicensed will be able to supply the new drug in combination with ritonavir (a drug used against the AIDS virus) to 95 countries, covering up to about 53% of the world's population." , said a spokesperson for Unitaid, Hervé Verhoosen, during the regular UN briefing in Geneva.

In early November, Pfizer, which already markets with the German BioNTech one of the most effective vaccines against Covid, revealed that in adults at high risk of developing a severe form of the disease, its oral antiviral PF-07321332 was 89% effective in preventing the risk of hospitalization or death, according to interim results from clinical trials.

With this agreement, Pfizer is following in the footsteps of its competitor Merck, which has entered into a similar pact with the MPP for its own oral anti-Covid, molnupiravir.

The latter also displays a high efficiency rate.

These promising results have yet to be confirmed, was careful to underline Esteban Burrone, head of policy development at the MPP.

But if so, availability "will be a matter of months, not years but not weeks either," he said.

Vital role

The agreement announced on Tuesday includes all lower and lower middle income countries and upper middle income countries in sub-Saharan Africa, as well as upper middle income countries that have achieved this status in the past five years, said Hervé Verhoosen. Pfizer will not receive royalties on sales in low-income countries and will further waive royalties on sales in all countries covered by the agreement as long as Covid-19 remains classified as a public health emergency of international concern by the World Health Organization.

"We believe oral antivirals can play a vital role in reducing the severity of Covid-19 infections, reducing the burden on our healthcare system and can save lives," commented Albert Bourla, CEO of Pfizer, in a joint statement. Pfizer and other pharmaceutical groups manufacturing anti-Covid vaccines are accused of prioritizing profits, selling to countries that can afford it and thus participating in the vaccine inequality between rich and poor countries.

For the moment the price is not known, indicated Esteban Burrone, but according to Médecin Sans Frontières it will be around 700 dollars in rich countries, as for molnuvipar, and its price will be adapted for others.

According to Esteban Burrone, “in a competitive environment (…) prices tend to fall at a bearable price”.

MSF said it was “discouraged” by this partial agreement, which excludes Argentina, Brazil or even China, Malaysia and Thailand, which have significant generic manufacturing capacities.

Change the game

The UK became the first country to authorize molnupiravir on November 4. These two antivirals work by decreasing the ability of a virus to replicate, thereby slowing down the disease. Easy to administer because they can be taken at home, these treatments are a complement to vaccines. Like molnupiravir, Pfizer's treatment, which will be marketed as Paxlovid, should be given within 3 to 5 days of the onset of symptoms.

These treatments are easier to manufacture than vaccines.

They do not require a cold chain and can be taken by the patient at home even if the need to use it quickly requires that tests are available and the diagnosis is confirmed by a doctor.

For Esteban Burrone, one of the crucial aspects is that these treatments can make it possible to relieve the health structures by preventing hospitalizations: “it changes the situation”.

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