The pill that treats Covid at home by ensuring 85% protection from severe forms risks remaining the prerogative of too few patients. And this time it is not the fault of the procedure that is too complicated to obtain it, which has recently been simplified: now the prescription from the family doctor is enough and the box of Paxlovid, the therapy developed by Pfizer, can be taken at the pharmacy. The problem is rather linked to the audience of possible “beneficiaries” which is currently limited only to patients who present at least one important pathology – active tumors, severe cardiovascular disease, chronic renal failure, etc. – who risk hospitalization, and excludes, for example, that of age alone among the election criteria.
WHO recommendations
It has been the WHO in recent days to recommend its widest possible use also for elderly patients; therefore a more massive use must be considered in view of the autumn, when it is likely that there will be new peaks of infections. Moreover, even today, when Omicron is raging, deaths are concentrated among the elderly: the almost 17 thousand deaths that have been counted since the end of January when Omicron was already 99% are 90% over 70. “I think it would be useful to understand immediately about deaths in recent months, given that we still turn to over a thousand deaths a week, what share of these could have benefited from the use of this antiviral and I believe that the numbers can be quite high “warns microbiologist Guido Rasi, former director of the European drug agency and for months adviser to Commissioner Figliuolo. For Rasi, the option of expanding the Paxlovid audience also to the elderly must be considered: “At this moment we must understand how to take full advantage of this therapy not only in view of autumn, but also now that we are still in a plateau of cases that goes down slowly. And I believe that it may certainly be appropriate to extend the prescription of this treatment to the over 70s, even if there is no major pathology. Obviously – Rasi warns – it is always essential to verify that there are no contraindications with the use of other drugs ».
Train family doctors
Rasi also suggests an expansion of the use of “preventive” abutments for the frail ones developed by AstraZeneca which show that they are able to reduce the risk of developing the disease by more than 80% after 6 months “to avoid deaths even more” . And he invites “family doctors to be trained more in the use of these new tools such as Paxlovid which is a combination of two drugs, one of which is ritonavir, used for 15 years in the population with HIV but which is also used in any case. pregnant. It is important to know its use well ».
In these days the first boxes of Paxlovid are arriving in the pharmacies of many Regions where patients can collect them by presenting a prescription from the family doctor. A significant simplification – previously it was necessary to go through the hospital centers – decided in mid-April by the Italian Medicines Agency that could give an important change to the prescriptions of this medicine, given that so far they have remained at a glance: in 72 days from his arrival in Italy – according to the latest AIFA report – less than 10 thousand doses have been dispensed, against an overall dowry of treatments ordered by Italy (which, however, it must be said, arrive in tranches) of 600 thousand doses.
To be used within 5 days of infection
Simplification was crucial because this cocktail of drugs must be taken within 5 days of infection to work, before the serious illness develops. «The main reason why pharmacies are involved is that if a drug is to be distributed quickly and widely, it must be prescribed by the family doctor and distributed by pharmacies. It is the synergy of the two figures that makes the prescription-dispensing system effective. All this is shown plastically in this situation », the president of Federfarma, Marco Cossolo clarified yesterday.