WHO recommends COVID-19 drug and urges transparency around prices


The WHO announced in Geneva on Friday that it has strongly recommended the use of nirmatrelvir and ritonavir, sold under the name Paxlovid, for mild and moderate COVID-19 patients at the highest risk of hospitalization.

The oral antiretroviral drug was developed by Pfizer and is “to date the best therapeutic choice for high-risk patients”, according to the UN agency.

“However, availability, lack of price transparency in the manufacturer’s bilateral agreements and the need for rapid and accurate testing before it is administered make this life-saving drug a major challenge for low- and middle-income countries.”

Reduced risk of hospitalization

Paxlovid is strongly recommended for patients with non-severe COVID-19 who are most at risk of developing serious illness and hospitalization, such as unvaccinated, elderly or immunosuppressed individuals.

The recommendation is based on new data from two randomized controlled trials involving more than 3,000 patients. The risk of hospitalization was reduced by 85 percent. In a high-risk group, that means 84 fewer hospital admissions per 1,000 patients.

Use for lower risk patients is not recommended as benefits have been shown to be negligible.

fear of inequality

One obstacle for low- and middle-income countries is that the drug should only be administered when the disease is in its early stages, making fast and accurate testing essential for successful results.

“Improving access to early testing and diagnosis in primary health care will be key to the global rollout of this treatment,” the WHO said.

The UN agency also feared that when it comes to access, poorer countries “is pushed to the end of the queue again”, as happened with COVID-19 vaccines.

General outlook limited

In addition, the lack of transparency on the part of the maker makes it difficult for public health organizations to get an accurate picture of the drug’s availability, as well as which countries are involved in bilateral deals and what they are paying.

In addition, a licensing agreement between Pfizer and the UN-backed Medicines Patent Pool (MPP) limits the number of countries that can benefit from the drug’s generic production.

Paxlovid will be included in the WHO’s prequalification list from Friday, but generic products are not yet available from quality-assured sources.

Prequalification means that the WHO has assessed a drug and meets international standards, making it eligible for purchase by national health authorities.

Make price agreements transparent

Several companies, many of which are covered by the licensing agreement, are in talks with WHO Prequalification, but it may take time for them to meet international standards so they can supply the drug internationally.

The WHO has strongly recommended Pfizer to make its prices and deals more transparent. The pharmaceutical giant was also urged to expand the geographic scope of the licensing agreement so that more generic manufacturers can produce the drug and make it available more quickly at affordable prices.

In other developments, the WHO has also updated its recommendation on another antiviral drug, remdesivir, suggesting it could be used in mild or moderate COVID-19 patients who are at risk for hospitalization.

Recommendation for use in patients with severe or critical COVID-19 is under review.

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