USA – Pfizer Inc has announced that the US government will pay US$5.29 billion for 10 million courses of its experimental COVID-19 antiviral drug, as the country seeks promising oral treatments for the disease.

The agreement covers roughly twice as many treatment courses as Merck & Co Inc has agreed to supply the US under its contract. The Pfizer pill is nearly 25% less expensive, costing around US$530 per course, compared to around US$ 700 for Merck’s.

Pfizer has applied for emergency approval of the drug, known as Paxlovid, after reporting data showing that it was 89 percent effective in preventing hospitalization or death in at-risk patients.

The findings of the trial suggest that Paxlovid outperforms Merck’s molnupiravir, which was shown last month to reduce the risk of death or hospitalization in COVID-19 patients at high risk of serious illness.

While this pill still requires a full review by the Food and Drug Administration, I have taken immediate steps to secure enough supply for the American people,” President Joe Biden said in a statement.

He added that his administration was making preparations to ensure the treatment is easily accessible and free.

Pfizer stated that if the treatment is approved by the FDA, it could begin deliveries as soon as this year. However, with the pill’s silver lining, getting vaccinated should remain a top priority for everyone.

Pfizer anticipates producing 180,000 treatment courses by the end of next month and at least 50 million courses by the end of 2022.

Equitable access

Pfizer has entered into advance purchase agreements for its antiviral pill with several other countries and has begun bilateral outreach to approximately 100 countries worldwide, declaring its commitment to working on “equitable access” to the treatment at an affordable price.

Pills are less expensive to produce than vaccines, do not require a cold chain for delivery, and can be self-administered by patients.

It announced a deal with the UN-backed Medicines Patent Pool (MPP) on Tuesday to sub-license production to generic manufacturers for supply in 95 low- and middle-income countries, accounting for roughly 53% of the global population.

Based on promising data reported by both companies, countries have scrambled to secure doses of Pfizer and Merck oral drugs.

In June, the US government announced a US$3 billion investment to accelerate the discovery, development, and manufacturing of antiviral medicines.

Paxlovid from Pfizer is a combination of a new molecule, PF-07321332, and the HIV antiviral ritonavir. Both belong to a class of antivirals known as “protease inhibitors,” which work by inhibiting the action of an enzyme required for viral replication. A five-day treatment course consists of one pill every 12 hours.

The US government has already purchased 3.1 million courses of an antiviral pill developed by Merck that is awaiting FDA approval for US$2.2 billion, with the option to purchase an additional 2 million courses in the future.

Animal studies have linked drugs in the same class as Merck’s pill to birth defects. Merck claims that similar studies of its drug, conducted for longer periods of time and at higher doses than those used in humans, show that it does not cause birth defects or cancer.

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