A substantial quantity of Pfizer’s Paxlovid, a crucial antiviral drug for Covid-19, has gone unused and expired in Europe, resulting in significant financial losses for purchasers. Stringent restrictions on the eligibility for receiving the medication have led to millions of doses being wasted, in stark contrast to the drug’s accessibility in the United States.
In Europe, access to Paxlovid has primarily been restricted to older adults and individuals at high risk of severe COVID, resulting in substantial underutilization. According to Airfinity’s analysis, over 1.5 million courses of the drug, valued at approximately $1.1 billion, have already expired, despite attempts to extend their expiration dates.
Such a trend is expected to persist, with an estimated total of around 3.1 million courses set to expire by the end of February 2024, potentially raising the cost to European health systems to about $2.2 billion. This calculation does not include EU-wide contracts.
Governments in Europe, including the UK, France, Spain, and Italy, may have overestimated the demand for Paxlovid during its initial availability in late 2021, coinciding with the emergence of the Omicron variant. Marco Gallotta of Airfinity suggests that the challenge of estimating demand during the pandemic resulted in excess purchases.
As COVID cases declined and testing was reduced, the need for these antivirals, which must be administered shortly after symptom onset, significantly diminished. This miscalculation has had a notable economic impact, with countries struggling to use their stockpiles before expiration, even after extending shelf lives.
With an estimated 1 million doses worth $700 million expiring by early December, the UK has been particularly hard hit. Another 550,000 doses are expected to expire in February, and an additional 650,000 by the end of June.
During the Omicron wave, the UK had agreed to purchase 2.75 million courses of Paxlovid, but strict prescription guidelines from the National Institute for Health and Care Excellence limited its use to individuals with serious health conditions. This approach differs from less stringent regulations in other European countries but does not alleviate the issue of wasted medication.
Globally, the demand for COVID antivirals has experienced fluctuations. Prescriptions for antivirals have dropped by 24% in the US, the largest market for COVID outpatient treatments, as of 2022.
The government intends to reimburse Pfizer for 7.9 million Paxlovid courses, at an estimated cost of $4.2 billion. As this was going on, Japan’s market for COVID-19 antivirals grew when Shionogi’s Xocova was approved for use in patients at standard risk. The initially robust market for Covid antivirals during the summer has prompted Shionogi to adjust its sales targets for Xocova, indicating a shift in global market dynamics for these treatments.
