New treatments for early Covid-19 are now arriving at pharmacies in New York and elsewhere, but they are still in short supply, according to a representative from the Infectious Diseases Society of America.
“I know patients who actually got outpatient prescriptions in New York City,” said Paxlovid of Pfizer Inc. Aaron Glatt, professor and chairman of the medical department at Mount Sinai South Nassau in Oceanside, New York, in an interview Thursday.
Doctors are eagerly awaiting the new drugs as highly transmissible omicrons spread across the US and the world, causing record case numbers in many regions. While the new variant appears overall less dangerous than previous strains, the sheer number of cases threatens health systems.
Molnupiravir from Paxlovid and Merck & Co. was approved by the Food and Drug Administration to prevent the need to admit high-risk outpatients. So far, they work better against Omicron than antibody therapies from Regeneron Pharmaceuticals Inc. and Eli Lilly & Co., which have been cleared for the same purpose.
Also very scarce: sotrovimab, the only monoclonal antibody known to work against the Omicron variant. GlaxoSmithKline Plc and Vir Biotechnology Inc. shipments of the infused drug are also expected to improve in the coming weeks, Glatt said.
Paxlovid suggested the other options in the updated guidelines issued Thursday by the US National Institutes of Health. In order of preference for treating non-hospitalized patients at high risk for severe Covid infections, the guidelines also listed sotrivimab, followed by infused remdesivir from Gilead Sciences Inc., and lastly molnupiravir.
Merck’s drug should only be used when the guidelines do not allow the other options. Molnupiravir works by inducing genetic defects and the FDA has advised against its use in anyone under the age of 18, or those who are pregnant or likely to become pregnant.
Currently, the drugs are only used in those at highest risk because of their scarcity, Glatt said. Pfizer has announced it will offer paxlovid courses to just 180,000 patients under a federal contract in 2021, but enough for millions by the next year.
Israel received its first shipment of Paxlovid on Thursday under an agreement with Pfizer to ship approximately 100,000 pills. Initial data suggest that the risk of hospitalization is reduced by almost 90%; Molnupiravir also appears to be effective, but much less effective, reducing the risk of hospitalization or death by about 30%.
The drugs may not be widely available in the U.S. right now, but care should improve in the coming weeks – after vacation schedules return to normal, Glatt said.
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