Research has raised concerns over Covid-19 drug Paxlovid’s cost-effectiveness, drug-drug interaction, and rebound potential. A recent study conducted by Public Health Ontario has found that the Covid-19 drug Paxlovid (nirmatrelvir–ritonavir) can reduce the risk of hospitalization and death by the disease but only for older patients.
The drug does not bear significant positive impacts on a younger population and this will cause healthcare providers and payers to reevaluate their use after it is no longer offered for free. This study has revealed that the drug is successful only in preventing 1 serious case of Covid in 62 cases and in order to better evaluate the cost-effectiveness for the drug, further stratification by age will be necessary to study the benefits of the drug in patients under the age of 70. Free supply for the drug will end in May once the public healthcare emergency in the U.S. ends.
“We observed substantial variation in the absolute risk reduction, which suggests that use of nirmatrelvir–ritonavir [Paxlovid] in populations at lower risk of COVID-19 may have limited population health benefits with important implications for its cost-effectiveness evaluations,” researchers said.
According to Kevin Schwartz, the lead author of the study, the evaluation of data from over 1,77,500 individuals revealed that nirmatrelvir–ritonavir effectively reduced the risk of hospitalization and all-cause death, these findings claimed Schwarts are corroborated by previous clinical trials and observational research. The results of the study were published in the Canadian Medical Association Journal. In the study, 8,876 individuals treated with Paxlovid were compared to 168,699 who did not get the drug. The individuals in the study were people infected with Covid-19 between April and August, 2022, in a polymerase chain reaction (PCR) test.
Despite being the most effective treatment for Covid, physicians in the U.S. have been reluctant to prescribe the drug to patients. According to a poll by the COVID States Project in July, of the adults 65 years of age and over who were diagnosed with Covid, only about 20% were prescribed with Paxlovid.
Not only this but there have been concerns that Paxlovid does not interact well with other drugs. However, research by Public Health Ontario was unable to confirm if participants in the study were concurrently taking interaction medication. Their research on the topic has concluded that Covid-19 patients with a level 2 drug-drug interaction can safely use nirmatrelvir–ritonavir. Researchers were also unable to determine if any potential drug–drug interactions were accounted for.
In addition, chances of a rebound, that is the emergence of Covid even after taking the prescribed courses of Paxlovid is a threat. Among people who experienced such a phenomenon famously are former top White House medical adviser, Anothony Fuci, and even the current President of the United States, Joe Biden.
The Centres for Disease Control and Prevention (CDC) in its morbidity and Mortality Weekly Report has also shared disparity in access to Paxlovid in Hispanic and black people compared to white and non-Hispanic people, and these disparities span across age groups and patients with who are immunocompromised.
