A new anti-Covid pill that reduces the risk of serious illness by up to 89% arrives in pharmacies in France this week. We look at what Paxlovid is, and who will be eligible to take it.
What is Paxlovid?
It is an antiviral pill that works to reduce the coronavirus’ capacity to replicate. It will work as a complement to vaccines.
It is to be taken orally twice a day for five days, in addition to a second medicine called ritonavir, another antiviral pill. Ritonavir is usually prescribed for HIV.
Also known by the name PF-07321332, Paxlovid is similar to the antiviral drug, Molnupiravir, which is produced by the US lab Merck.
A study by Pfizer, published in November 2021, said that this treatment reduces the risk of hospitalisation and death in high-risk, non-vaccinated adults by up to 89% in the three days following symptoms.
This is a slightly higher efficacy score than the one found by French health authority la Haute Autorité de Santé (HAS), which found it reduced the risk by 85%.
Side-effects of the drug in the clinical trials were “moderate”, Pfizer said.
It was given emergency approval by the European Medicines Agency (EMA) for use in the EU on December 16, 2021, and was approved by the HAS for “early, temporary use” on January 21, 2022.
Who will Paxlovid be used for?
It will be used on patients who are suffering from intense symptoms, before their illness becomes bad enough to require hospitalisation or intensive care admission.
It will only be available on a doctor’s prescription, and patients will need to have a doctor consultation before taking it. The doctor will generate a specific QR code for use in a pharmacy, and the pharmacist will also have to ask questions for verification before dispensing the drug.
It will be mainly intended for two categories of patients.
The first will be adult patients who are immunocompromised or have a high risk of severe forms, whatever their age or vaccination status.
The second will be patients over 65 years of age who are at risk of developing severe forms of the disease (because they have other conditions such as diabetes, obesity, heart failure, or respiratory failure), particularly if they are not vaccinated.
Not everyone in these groups will be eligible automatically.
There is also a number of medications that interact with Paxlovid, and the HAS said that the drug is not recommended for people with liver problems.
When will it be available?
It is set to be available in pharmacies in France this week. Health Minister Olivier Véran has previously confirmed that “France will be in a position to have it by the end of January”.
A total of 500,000 doses have been ordered, but only several thousand will be available in the coming days, with use expected to be limited initially.
Will it replace vaccines?
No, Paxlovid will not replace vaccines.
While it is recommended especially for people who are not vaccinated (especially those who cannot be vaccinated for health reasons), its use is still intended to act as a complement to vaccines, rather than a replacement.
Professor Mathieu Molimard, head of the medical pharmacology department of the Bordeaux University Hospital, told FranceInfo: “The best treatment remains the vaccine, with a booster, which protects against hospitalisation by more than 80%, even for the Omicron variant, and by up to 90% the risk of admission to intensive care.”
He added: ”This is a drug that we don't know much about yet, it's been tested on two or three thousand people, maybe a few thousand in the United States.
“For the moment, we have to give it to those who really need it, in whom we can take the risk because if they don't have this drug, they have a great chance of dying. [But] we have relatively few drugs. The most effective medicine is vaccination.”
How else will Paxlovid affect France?
Pfizer is set to invest more than €520million in France over the next five years, both for the production of Paxlovid, and in French biotechs.
The drug’s main active ingredient will be produced in Mourenx (Pyrénées-Atlantiques), after an agreement with French pharmaceutical group Novasep.
It will also significantly increase its clinical trials with French patients, said Pfizer CEO Albert Bourla. He told Le Figaro that France is "a competitive country" and that “reforms” had made it an attractive place to invest.
Pfizer plans to produce 120 million boxes of Paxlovid worldwide from this year onwards.