Home Health Pfizer’s Covid Paxlovid antiviral in the pharmacy: what to know

Pfizer’s Covid Paxlovid antiviral in the pharmacy: what to know

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Pfizer’s Covid Paxlovid antiviral in the pharmacy: what to know

Finally also Covid can be treated at home. In fact, starting from 21 April, too general practitioners can prescribe Pfizer’s antiviral drug Paxlovidbased on nirmatrelvir / ritonavir, for the early treatment of Covid.

Who can take Paxlovid

Pfizer’s oral antiviral drug, a combination of nirmatrelvir and ritonavir tablets, is strongly recommended for patients with non-severe Covid who are at higher risk of developing severe illness and hospitalizationsuch as unvaccinated, elderly or immunosuppressed patients.

This recommendation is based on new data from two randomized controlled trials involving 3,078 patients. The data show that the risk of hospitalization is reduced by 85% following this treatment. In a high-risk group, i.e. where over 10% are at risk of hospitalization, this translates into 84 fewer hospitalizations per 1000 patients.

Paxlovid is indicated for the treatment of adult patients who do not need supplemental oxygen therapy and who are at high risk of progression to severe Covid, such as patients suffering from oncological diseases, cardiovascular diseases, uncompensated diabetes mellitus, chronic pulmonary disease and severe obesity.

While it has been somewhat incredibly discovered that more people die of Covid in two specific days (here we have explained why), treatment must be started as early as possible, and in any case within 5 days from the onset of symptoms.

How the GP’s prescription works

However, the prescription of the drug always requires a preventive drug history, to exclude the presence of any interactions with drugs taken at the same time by the patient.

The prescription by the general practitioner takes place via the compilation of a treatment plan, which is currently on paper and which will be computerized within a few weeks, to check for any interactions with other drugs that could be incompatible.

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With the prescription of the general practitioner, the patient can collect the drug directly at the pharmacy, free of charge and without charges for the NHS. The distribution to the pharmacy network, through the so-called distribution on behalf, will take place free of charge by pharmacists and wholesalers, thanks to a Memorandum of Understanding between the Ministry of Health, AIFA and the network of pharmacies (Federfarma, Assofarm and FarmacieUnite) and distributors. pharmaceuticals (Federfarma Servizi and ADF).

However, prescription by all Covid specialist centers identified by the Regions remains possible. This modality will guarantee access to the drug in the phase of activation of distribution by pharmacies to the public, as well as in the event that distribution by pharmacies is temporarily unavailable.

WHO also recommends the drug, but here are the problems

While new symptoms are increasingly associated with the “new” Covid, right now too WHO made a strong recommendation for nirmatrelvir and ritonavir, sold under the name Paxlovid, for mild and moderate Covid patients at higher risk of hospital admissioncalling it the best therapeutic choice for high-risk patients to date.

However, the availability, lack of price transparency in bilateral agreements entered into by the manufacturer and the need for timely and thorough testing before administration are turning this life-saving drug into a major challenge for low- and middle-income countries.

An obstacle for low- and middle-income countries is that the medicine can only be given while the disease is in its early stages. But to do this you need timely and accurate testing. Unfortunately, the data collected show that the average daily test rate in low-income countries is as much as one-eightieth compared to high-income ones.

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Improving access to early testing and diagnosis in primary health care settings will therefore be key to the global introduction of this treatment. Not surprisingly it is There is a strong concern that, as happened with vaccines, low- and middle-income countries will again be excluded from treatment (here how Covid symptoms have changed with the Omicron 2 variant).

The WHO also denounced that the Pfizer’s “lack of transparency” it is making it difficult for public health organizations to get an accurate picture of the drug’s availability, which countries are involved in bilateral agreements and how much they are paying.

The crux of anti-Covid generic drugs

Not only. A licensing agreement entered into by Pfizer with the Medicines Patent Pool would limit the number of nations that can benefit from generic production of the medicine.

The original product, sold under the name Paxlovid, was included in the so-called WHO pre-qualification list, but generics are not yet available. Several generic drug companies, many of which are covered by the licensing agreement between Medicines Pool and Pfizer, are discussing this, but it may take a long time to comply with international standards so that they can supply the medicine internationally.

WHO therefore strongly recommends Pfizer to make its pricing and agreements more transparent and to broaden the geographic scope of its license with the Medicines Patent Pool. so that more generic manufacturers can start producing this medicine and make it available faster at affordable prices.

The news on remdesivir

Along with the strong recommendation for the use of nirmatrelvir and ritonavir, WHO also updated its recommendation on remdesivirthe other antiviral drug used to treat Covid.

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Previously, WHO had suggested the use of remdesivir in all Covid patients regardless of disease severity, due to evidence at the time showing little or no effect on mortality.

Following the publication of new data from a clinical study examining the outcome of hospital admissions, the World Health Organization instead updated its recommendation, explaining that now the use of remdesivir is advised in patients with mild or moderate Covid who are at high risk of hospitalization. The recommendation for the use of remdesivir in patients with severe or critical Covid is currently under review.

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