The Covid treatment pill is here – and big pharma will ultimately decide who gets it | Ottoman Mellouk


VSovid-19 has quietly become the gift that continues to be given to big pharma. Over the past two years, he has reaped huge profits from Covid vaccines, while simultaneously opposing wider sharing of the technology needed to make them. And now there’s a new source of money on the rise: Covid antiviral treatment pills. Once again, we are about to fall into the same inequality traps we are caught in with the global rollout of the vaccine.

Pfizer and Merck have new antiviral pills hitting the market fast – Paxlovid and Molnupiravir respectively. As with the vaccines that preceded them, the two companies are on a mission to ultimately decide who can create generic versions through the medical patent system – a crucial and life-saving issue for millions of people around the world.

And business certainly looks promising. Pfizer alone, freshly cemented as the global kingpin of the Covid-19 vaccine, expects to make up to $22 billion from its new pill this year, on top of the $37 billion it made in 2021 thanks to the vaccine.

The new drug is not cheap. Pfizer’s Paxlovid currently costs around $530 for a five-day course. Merck’s molnupiravir, now approved for use in the UK, costs around $700. The cost of producing molnupiravir would be around $17.74.

The familiar alarm bells should ring. Experts on all sides predict that the demand for antiviral drugs will quickly outstrip the supply. A World Health Organization report produced in January warned of a “high risk of shortage” of Paxlovid for low- and lower-middle-income countries until generic versions are more widely available, which which should not be the case before the second half of 2022 at the earliest. Separate analysis from data and analytics firm Airfinity suggests that could be as late as early 2023. After uneven global vaccine rollout, low-income countries also face the prospect of a “Wild West for life-saving pills.

Pfizer and Merck have chosen to nominate a few select generic manufacturers capable of producing cheaper versions of their drugs, through the Medicines Patent Pool (MPP). But even with these agreements in place, they remain firmly under control and access to generic versions is only within reach of half the world’s population.

A number of countries including Argentina, Brazil, Thailand, Russia, Colombia, Peru, Turkey and Mexico have again been excluded from these licenses and must try to make deals for the more expensive products. With so many prices off the market, global sourcing will once again be prioritized by rich countries, as companies refuse to make affordable generic antivirals available to everyone, wherever they are needed.

It’s a grim mirror of the dramatically unequal vaccine supply at the start of the pandemic, when wealthy countries bought far more doses than they could use. The United States, where almost two-thirds (65%) of the population is already fully immunized, is said to have invested more than $10 billion in Pfizer’s Paxlovid, more than double the total GDP of Sierra Leone, where only 9% of people have the same protection. For less wealthy countries, competition is not even an option.

Meanwhile, Merck is pursuing its “evergreening” patent strategy to extend its monopoly on molnupiravir beyond the standard 20-year protection. Since developing the pill, he has applied for at least 53 patent applications to lock it into legal bureaucracy and keep tight control over who can make it and where. It has already received emergency approval in the US and Japan, and been given the green light in the UK.

Even in MPP countries, where pills are allowed to be produced by certain manufacturers, low cost is not guaranteed. Dr. Reddy’s labs in India have made a generic version of Merck’s pill that costs $18 for one treatment. However, these costs will not necessarily be passed on everywhere. Across the border in Bangladesh, Pfizer’s generic version of the pill will cost upwards of $170 for a treatment – a cost prohibitive for much of the population. By restricting the manufacturers who can produce a generic version, companies retain considerable control over the final price. In the past, the price of sofosbuvir, Gilead’s treatment for hepatitis C, only fell steadily as the number of manufacturers increased without these limits.

There is an uncomfortable assumption that those in the Global North have tacitly begun to accept. When demand exceeds supply, there is a pecking order: rich countries first, buy more than they really need, while poorer ones are forced to scramble to outbid what is left. , overpay significantly, or just wait until they’re affordable and see the death toll rise. But this supply crisis is entirely artificial. We could produce more – the drugs from Pfizer and Merck are not complex and could be easily manufactured in a wide range of developing countries if they had access to the know-how and could avoid the threat of legal action. We need patents and other intellectual property barriers on lifesaving medicines to be removed – either voluntarily by companies or by government decree – so that we can quickly supply every country in the world.

We double down on a two-tiered world when it comes to Covid-19 – wealthy, highly vaccinated nations with easy access to preventive measures and treatments, and poorer nations trying to get by without one or the other. ‘other. It’s critical that we don’t sleepwalk by giving companies so much control over who lives and who dies, all balanced against what they deem to be an acceptable outcome.


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