When President Joe Biden contracted COVID-19, he was almost instantly prescribed Paxlovid, the antiviral designed to treat the virus that reduces the risk of hospitalization or death by 89%.
It was an uncontroversial decision to administer the medication to the 79-year-old. Dr. Kevin O’Connor, the physician to the president, said Biden completed his Paxlovid five-day course and has now tested negative twice. But Biden almost certainly would not qualify for the treatment under U.K. guidelines.
Through July 17, the U.S. has administered 2.8 million courses of Pfizer’s
Paxlovid, and more than a million doses of other therapeutics, including Merck’s
Lagevrio. Through the same date, the National Health Service of England has administered just under 60,000 courses of all therapeutics, including more than 29,000 for the intravenous Xevudy from GSK
and just over 18,000 courses of Paxlovid.
Put another way, the U.S. has about five times the population and yet distributed 155 times the number of Paxlovid courses. It’s not a matter of supply — the U.K. has contracted for 2.75 million courses of Paxlovid.
The results have not been great for the U.K., though it’s not clear the degree to which that’s the result of antiviral usage. Hospitalizations per million in the U.K. from COVID-19 have been running north of 250, compared to 115 in the U.S., even though the U.S. has a higher number of new cases per million, at 383 versus 295.
A spokesman for the NHS referred questions to the Department of Health and Social Care, saying it’s responsible for deciding which cohorts of highest-risk patients are eligible for antivirals.
The government said it’s going with its current approach in part because it wants to stockpile supplies in case a new variant overwhelms vaccines.
“This supply of antivirals will allow the NHS to treat vulnerable people who are infected with Covid, as well as protect the population in the event of a future variant of concern that may reduce vaccine efficacy,” the agency said in a statement.
“Our plan has always been to prioritize giving antiviral medicines to those at greatest risk, while the PANORAMIC national study collects additional U.K.-wide data on how antivirals work on vaccinated people and who would benefit most from receiving these treatments.”
That study is enrolling people over 50, or those younger with comorbidities, and have COVID. To get Paxlovid in that study, a person must be an existing patient at one of the handful of participating clinics, none of which are in the capital of London.
At the current rate, the U.K. will end up with a stockpile of Paxlovid it can’t use. According to both the U.S. Food and Drug Administration and the U.K. Medicines & Healthcare products Regulatory Agency, the shelf life for Paxlovid is one year.
Pfizer said in a statement that it’s up to the health authorities of each country to determine their use. “Our role in the U.K. is to support with the manufacture and delivery of Paxlovid to the Government’s nominated distribution centers. Onward deployment to eligible patients is then handled by the NHS,” the company said.
This reporter witnessed the approval process firsthand as my 86-year-old mother-in-law, with kidney problems and an epileptic history, was denied repeated requests for antivirals. An appeal found its way to a doctor on the NHS COVID-19 Medicine Delivery Unit, who works at the highly regarded Chelsea and Westminster Hospital.
The doctor, who didn’t identify herself, said my mother-in-law would have had to be receiving dialysis to qualify, or fighting cancer or HIV. And she’s frequently encountered frustrations from expat Americans who don’t understand why they’re not receiving the drug.
“A lot of Americans are very unhappy with me,” she said.