Slow Rollout Means Antiviral COVID-19 Medications are Too Late for Worst of Omicron

The authorization of the first medications to blunt the effects of a severe COVID-19 infection was expected to be a game-changer. However, the delayed scale-up in production means the antivirals will not be widely available until well after the destruction of the omicron surge.

The two antiviral medications from Pfizer and Merck — called Paxlovid and molnupiravir, respectively — were authorized by the Food and Drug Administration last month for people at high risk of developing severe infection due to COVID-19. Paxlovid was authorized for people 12 and older, while Merck’s treatment can only be prescribed to adults.

However, doctors and pharmacists say the courses of treatment sent to states so far are just a drop in the bucket. They argue the Biden administration should have planned better by purchasing more supplies and directing manufacturers to begin production in advance.

“To have Paxlovid before the omicron surge would have been really, really helpful, and I think when you look at the way the government had advanced purchase agreements with vaccine manufacturers, some of this should have been also thought about,” said Dr. Amesh Adalja, an infectious disease expert at Johns Hopkins Center for Health Security.

Antiviral medications will be a powerful bulwark to keep the shaky medical system afloat amid record-high hospitalizations. But to be a game-changer, the medication must be accessible to those who qualify, such as the unvaccinated, the immunocompromised, the obese, and older adults who test positive for COVID-19. Millions of people in the early stages of infection would qualify for the antivirals, but limited supplies severely limit who can benefit from them.

The Biden administration has so far purchased 20 million courses of Paxlovid and enough molnupiravir for 3.1 million people. While the administration purchased those courses of molnupiravir in advance of authorization, it's still not enough.

Merck’s treatments are expected to be available by the end of the month. However, Pfizer’s first 10 million doses are not likely to become available until the end of June, as the pills take about six to eight months to produce, according to the White House. Jeff Zients, the coordinator of President Joe Biden's pandemic response team, said in December there would be "265,000 treatment courses of Pfizer available in January, with monthly totals of pills ramping up across the year.” The other 10 million courses of Paxlovid will come by the end of September.

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