OTTAWA – Health Canada has approved Pfizer’s drug Paxlovid as the first take-home treatment for COVID-19.
The drug, which is a treatment involving a total of six pills taken daily for five days, has been shown to reduce the risk of hospitalization by almost 90 per cent. The course of treatment includes two pills of nirmatrelvir taken twice a day and one pill of ritonavir taken twice a day.
The drug prevents the virus from replicating, which helps people recover faster. It can’t be taken by people under 18 years of age. There are also several drugs that can’t be taken alongside Paxlovid, including drugs for cancer, high blood pressure and some anti-anxiety and depression medications.
To be effective, the drug requires people to start treatment within five days of having symptoms and while they can take it at home, it must be prescribed to them and they must have a positive COVID-19 test to begin treatment.
As the Omicron wave has driven cases skyrocketing, testing centres have been overwhelmed and most provinces now limit who can get a PCR test. Even people who can receive tests are often waiting several days for results.
Dr. Theresa Tam, Canada’s chief public health officer, said in the interim, physicians can use rapid antigen tests to prescribe the pills.
She admitted in the short term it will have a limited benefit, but said it will help some people and could be an important tool in the future.
“For the Omicron wave itself, it may contribute, but it won’t be a key contributor to the current wave,” she said. “We think everybody really just needs to give it a good try because it will be, I think, an important tool going forward.”
Provinces will receive shipments on a per-capita basis and will be the ultimate arbitrators of who gets the medication while it is in short supply.
The public health agency is recommending immunocompromised people are the top priority for the medication, followed by unvaccinated or partially vaccinated people over 80 years old, people in their 60s and people in rural and remote communities where access to hospital care could be difficult.
Tam said the unvaccinated are high on the priority list, because they are more likely to end up in hospital with severe illness.
“As health-care providers, you don’t pick and choose which patients you have coming into the hospital and getting treated. And so I think this approach ensures that we are prioritizing treatments to those most in need,” she said.
She stressed however the treatments are no substitute for vaccination.
“This is another tool in the toolkit to fight the pandemic. It is important that everyone gets fully vaccinated and receive a booster, as soon as they are eligible.”
Alexandra Hilkene, a spokesperson for Ontario Health Minister Christine Elliott, said the province is expecting it will get 10,000 courses of the drugs in January and has worked out plans to distribute them.
“We have worked with our hospital partners and are prepared for distribution of antivirals at 15 sites across the province as soon we receive them. Courses will initially be prioritized for adults with the highest risk of severe outcomes including immunocompromised patients, and could help keep thousands of people out of our hospitals,” she said in an email.
Hilkene said the pills could help the province return to normal and ease restrictions.
“The arrival of these pills gives us increased confidence as we continue to review key indicators and data to determine when we can begin safely and gradually lifting public health measures.”
A first shipment of the pills arrived in Canada over the weekend, with just over 30,000 courses of treatment arriving.
Procurement Minister Filomena Tassi, said Canada expects another 120,000 courses to arrive before the end of February as part of the initial order for a million treatments, with more to come after that.
The government also has an option for 500,000 more courses of treatment after that. The U.S. government bought 10 million courses for US$5.29 billion, a cost of roughly US$529 per course of treatment.
Tassi would not say what Canada paid for the pills, but said the government was committed to doing whatever is necessary to help Canadians dealing with the virus.
“In order to protect the commercially sensitive pricing information, we can’t disclose those details,” she said. “The health and safety of Canadians has been our top priority from a procurement perspective whether it’s vaccines, PPE, medical supplies. We’ve done everything that we can possibly do with the priority of keeping Canadians safe.”
The government has also refused to disclose on a per dose basis what it paid for COVID-19 vaccines.