After the vaccines, the Paxlovid pill produced by Pfizer was seen as the great hope for putting an end to Covid-19: it is 89% effective in reducing the number of people admitted to hospital and deaths and it works against all the variants, including Omicron. On 27 January the European Medications Agency gave the green light to these pills and Spain’s Ministry of Health quickly ordered some.
Health minister Carolina Darias said on 24 March, when she signed the contract with Pfizer for 344,000 complete treatments at a cost of 238 million euros (691 euros each), that it was a very important step towards saving lives. About 50,000 treatments were distributed to the different regions of Spain, but barely 2.35% (1,218 treatments) have been administered.
Several experts have said the instructions about who could receive the treatment were not clear. According to the Spanish Medications and Health Products Agency, people who have not been vaccinated against Covid, or the over-80s who are vaccinated but have at least one risk factor for coronavirus, should be given priority. That ruled out most of the over-60s, because 98% of people in that age group 98% have been fully vaccinated.
Another problem has been that although a GP or hospital doctor can prescribe the pills to a patient who has tested positive, fewer tests are being carried out in this new phase of the pandemic and Covid patients who have done a test at home but not gone to a health centre have no access to Paxlovid.
Strangely, “psychological problems” are said to be why the pill has not been used in several regions. One doctor has said that some health authorities are just too scared to use Paxlovid: the same situation occurred with the Tamiflu medication during the bird flu pandemic in 2006: many doctors still have plenty of supplies which were never used.
Moreover, Paxlovid is not compatible with many other drugs, and that is also restricting its use. Doctors can prescribe it, but it is hospital pharmacies who check whether a patient is taking other medication which is incompatible and that is often the case. This is why many doctors are prescribing the Merck antiviral medication instead: it is not as effective but it is compatible with many more drugs.
The spokesperson for the Spanish Society of GPs and Family Doctors, Lorenzo Armenteros, says it is a shame that more use is not being made of Paxlovid. “We suspect that many patients currently in hospital could have benefited from the medication,” he says.