Pepperrell Toby, Ellis Leah, Wang Junzheng, Hill Andrew
School of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
Faculty of Medicine, Imperial College London, London, UK.
Open Forum Infect Dis. 2022 Apr 7;9(9):ofac174. doi: 10.1093/ofid/ofac174. eCollection 2022 Sep.
Pfizer and the Medicines Patent Pool (MPP) have reached a voluntary licensing agreement for Paxlovid (nirmatrelvir+ritonavir), a novel antiviral for coronavirus disease 2019 (COVID-19) taken orally in the first 5 days from symptom onset. The Pfizer-MPP deal enables 95 low- and middle-income countries (L/MICs) to access affordable biosimilars. Generics are delayed awaiting bioequivalence testing and may be ineffective in L/MICs with reduced testing capacity, which comprise only 10% of global diagnoses. Thirty-nine percent of diagnoses originate in MICs forced to pay high prices due to exclusion from the Pfizer-MPP deal. The cost-effectiveness of Paxlovid could be limited compared with the creation of sustainable vaccine infrastructure in these nations, delaying socioeconomic pandemic recovery. Furthermore, Paxlovid may not be cost-effective in vaccinated populations, and concerns remain over ritonavir drug interactions with COVID-19 comorbidity medications. We call for expanded coverage by the Paxlovid-MPP deal and greater access to testing.
辉瑞公司与药品专利池（MPP）就帕罗韦德（奈玛特韦+利托那韦）达成了一项自愿许可协议。帕罗韦德是一种用于治疗2019冠状病毒病（COVID-19）的新型抗病毒药物，需在症状出现后的头5天内口服。辉瑞与MPP的协议使95个低收入和中等收入国家（L/MICs）能够获得价格可承受的生物类似药。仿制药因等待生物等效性测试而延迟供应，并且在检测能力较低的L/MICs国家可能无效，而这些国家仅占全球确诊病例的10%。39%的确诊病例来自中等收入国家，由于被排除在辉瑞与MPP的协议之外，这些国家被迫支付高价。与在这些国家建立可持续的疫苗基础设施相比，帕罗韦德的成本效益可能有限，这会延缓社会经济层面的疫情恢复。此外，帕罗韦德在已接种疫苗的人群中可能不具有成本效益，并且人们仍对利托那韦与COVID-19合并症药物之间的药物相互作用存在担忧。我们呼吁扩大帕罗韦德与MPP协议的覆盖范围，并增加检测机会。
