When clinical trial data for the antiviral drug Paxlovid emerged in late 2021, doctors hailed its incredible effectiveness, leading to a nearly 90 percent reduction in the risk of severe COVID-19.
But more than a year later, COVID-19 is still a leading cause of death in many countries, not just low-income countries where there is a shortage of this drug. In the United States, for example, hundreds of people still die every day from COVID-19 nature Scientific.
Researchers say the drug’s launch has been hampered by concerns about ‘rebound’ (the mysterious return of symptoms or detectable virus days after a person begins to feel better) and side effects – and also by reduced concern about the risk of COVID-19. Inadequate funding for distribution, the high price of the drug, and the need to take it soon after infection also slowed its administration.
As a result, doctors have only prescribed the drug for around 0.5% of new cases of COVID-19 in the UK and around 13% in the US, according to a report by health analytics firm Airfinity.
Sentiment against the drug persisted even as regulators globally revoked licenses for a monoclonal antibody therapy against COVID-19, leaving Paxlovid as one of the only tools to prevent death in high-risk individuals, says Davey Smith, an infectious disease physician at the University of California, San Diego…
“It’s a breakthrough drug that has good efficacy, even in the Omicron environment,” Smith says. “But recovery has been proposed as a reason not to take the drug, which is unfortunate.”
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Paxlovid is a combination oral antiviral drug that reduced the risk of hospitalization or death by 89 percent in high-risk individuals who took the drug within three days of symptom onset, according to a clinical trial sponsored by Pfizer, which produces the drug.
US regulators first cleared Paxlovid in December 2021 and have since eased restrictions on who can prescribe the drug in a bid to make it more widely available.
But health officials say the drug hasn’t been used as often as expected: About 10 million cycles of Paxlovid have been delivered to the United States, but only about 6.7 million have been used.
This underuse stems in part from misinformation and misconceptions about the drug, says Daniel Griffin, MD, an infectious disease physician at Columbia University in New York City.
For example, people perceive COVID-19 as less severe than before during the pandemic, Griffin says, making them less likely to seek treatment and doctors less likely to prescribe drugs right away.
Paxlovid works by inhibiting viral replication, which mainly occurs early in the course of the disease.
This means that the drug must be taken within the first five days of symptom onset, leaving a narrow window of time for people to receive treatment.
And that doesn’t sit well with the “let’s wait and see” mentality that circulates among doctors treating people with COVID-19, Griffin says.
Adding to the confusion, fears about the virus’ “rebound” after taking the drug have grown, and such advertising has had a chilling effect on the number of people seeking Paxlovid, Smith says.
But the researchers found that recovery often occurred even in people who weren’t taking Paxlovid3.
Recovery from symptoms tends to be very mild, Smith says, and is still much better than hospitalization or death.
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Additionally, Paxlovid can’t be taken with many other medications, and in some people, the drug gives certain foods a bitter or metallic taste, both of which reinforce the perception that it’s toxic, Smith says.
But there are also institutional reasons for the lack of uptake, says Anne Susen, a public health policy specialist at Dartmouth College in Hanover, New Hampshire.
Sosin notes that the drug relies on a robust COVID-19 testing infrastructure and access to primary care physicians and pharmacies.
This amplifies pre-existing differences in race and income. For example, black and Hispanic populations were 36% and 30% less likely to receive Paxlovid prescriptions than white populations, and Sosen says concerns about reluctance provide an excuse to blame individuals rather than those responsible politicians and draw “attention away from the system it should be in place to deliver.” pharmaceutical”.
