USA – Pfizer, a US pharmaceutical company, has signed an agreement that will allow other drug companies in 95 countries to produce its COVID-19 antiviral treatment candidate for low- and middle-income countries, according to Medicines Patent Pool (MPP).

 Under the terms of the license agreement between Pfizer and the MPP, qualified generic medicine manufacturers worldwide were granted sub-licenses to supply the new drug in combination with ritonavir to 95 countries, mostly in Africa, Asia, and some in South America.

Medicines Patent Pool (MPP) is a United Nations-supported public health organization that works to improve low- and middle-income countries’ access to medicines. With the agreement, it would cover up to 53% of the world’s population.

According to Pfizer, Paxlovid is an oral investigational SARS-CoV-2 protease inhibitor antiviral therapy that can be prescribed at the first sign of infection or at the first awareness of an exposure, potentially saving lives.

Paxlovid is intended to inhibit the activity of the SARS-CoV-2 protease enzyme required for coronavirus replication.

Co-administration of this therapy with a low dose of ritonavir slows the metabolism, or breakdown, of Paxlovid allowing it to remain active in the body for longer periods of time at higher concentrations, assisting in the fight against the virus.

While COVID-19 is still classified as a Public Health Emergency of International Concern by the WHO, Pfizer will not receive royalties on sales in all countries covered by the agreement, including low-income nations.

It should be noted that some countries are not eligible for the agreement. According to the New York Times, these countries are Brazil, Cuba, Iraq, Libya, and Jamaica.

A similar agreement was reached between MPP and Merck for its oral antiviral, Molnupiravir, and both the Merck and Pfizer agreements exclude Brazil, China, and Russia. All of these countries would have to purchase the antiviral from pharmaceutical companies directly.

Molnupiravir, has been shown to cut the risk of death or hospitalization in COVID-19 patients at high risk of serious illness in half.

Then there’s Evusheld, a new COVID drug from AstraZeneca. Australia’s Therapeutic Goods Administration (TGA) has only recently issued this “provisional determination,” which means the company can now submit data for evaluation.

Evusheld contains two monoclonal antibody drugs with a long half-life – tixagevimab and cilgavimab. It’s an injection that can be given in the hospital or as an outpatient to keep infections from worsening.

Human trials have shown that when Evusheld was used prior to COVID exposure, there were significantly fewer symptoms.

Why Pfizer, MPP deal is important

This license is so important because, if authorized or approved, this oral drug is particularly well-suited for low- and middle-income countries and could play a critical role in saving lives, contributing to global efforts to fight the current pandemic.

What distinguishes this from other therapies used since the outbreak’s inception is that it allows patients to be treated at home using a combination of a capsule and a pill.

The Pfizer and Merck pills are eagerly awaited, as there are currently only a few options for treating COVID-19 patients.

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