E-DRUG: Potential impacts of PF-07321332/ritonavir scale-up on markets for HIV medicines
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Christa Cepuch (MSF), Ameet Sarpatwari (PORTAL/Harvard), and I have a short
piece out today in The Lancet HIV about potential impacts of
PF-07321332/ritonavir scale-up on markets for HIV medicines.
https://www.thelancet.com/action/showPdf?pii=S2352-3018(21)00321-0.
I have been working on the broader issue of direct and indirect supply chain effects from COVID-19 -- would be glad to talk to folks working on similar issues.
Blurb below:
A comment published on December 7 in the UK medical journal *The
Lancet HIV argues that Pfizer's plan to manufacture 80 million courses of their investigational COVID-19 treatment Paxlovid (PF-07321332/ritonavir) couldcause shortages of HIV treatments. Ritonavir, one of two active ingredients in the Paxlovid combination, is also a key ingredient in HIV treatment cocktails (ritonavir-boosted lopinavir and ritonavir-boosted atazanavir) used by at least 1 million adults and 500,000 children in low- and middle-income countries.
Analysis of export data suggests that ritonavir markets were already
disrupted by the surge in demand in March 2020 when ritonavir-boosted
lopinavir was first considered as a potential treatment COVID-19. Should
Pfizer's application for emergency use authorization (EUA) be successful,
market disruptions would be far greater than in this earlier surge, and may
interrupt the supply of ritonavir needed for HIV treatment unless immediate
preventative actions are taken.
Stockpiling has been seen for other medicines that were expected to be
useful for COVID-19, with downstream supply interruptions and shortages for
people who were using them for treating chronic conditions. In March and
April 2020, shortages of hydroxychloroquine and salbutamol were reported,
affecting patients who take these drugs for lupus and asthma.
To date, Pfizer has claimed they can manufacture 80 million courses by the
end of 2022. PF-07321332/ritonavir has not been approved for emergency use
by any regulatory authority. The US government has purchased 10 million
courses. The UK government purchased 250,000 courses. Pfizer has signed a
licensing agreement with the Medicines Patent Pool (MPP); however, the
agreement excludes a number of countries experiencing significant COVID-19
outbreaks, including Argentina, Brazil, Russia, and Thailand.
Sincerely,
Melissa
Melissa Joy Barber
Department of Global Health and Population, Harvard T H Chan School of Public
Health, Boston
Melissa Barber <melissajoybarber@gmail.com>