As Omicron Spreads Across US, New Covid Drugs In Short Supply

New treatments for early Covid-19 are now beginning to arrive at pharmacies in New York and elsewhere but remain in short supply, according to a representative of the Infectious Diseases Society of America.

"I know patients who have actually gotten outpatient prescriptions in New York City" of Pfizer Inc.'s Paxlovid, Aaron Glatt, professor and chair of the Department of Medicine at Mount Sinai South Nassau in Oceanside, New York, said Thursday in an interview. 

Doctors are anxiously awaiting the new medications as highly transmissible omicron spreads across the U.S. and the world, leading to record case numbers in many regions. While the new variant appears less dangerous overall than earlier strains, the sheer number of cases is threatening health systems. 

Paxlovid and Merck & Co.'s molnupiravir have been authorized by the Food and Drug Administration to keep non-hospitalized high-risk patients from needing admission. So far, they work better against omicron than antibody therapies from Regeneron Pharmaceuticals Inc. and Eli Lilly & Co. that were cleared for the same purpose. 

Also still in very short supply: sotrovimab, the only monoclonal antibody known to work against the omicron variant. Supplies of the infused drug from GlaxoSmithKline Plc and Vir Biotechnology Inc. are also expected to improve in the coming weeks, Glatt said.

Paxlovid beat out the other options in updated guidelines issued Thursday by the U.S. National Institutes of Health. In order of preference for treatment of non-hospitalized patients at high risk of severe Covid, the guidelines also listed sotrivimab, followed by Gilead Sciences Inc.'s infused remdesivir and, in last place, molnupiravir. 

The Merck drug should  be used only when the other options can't be, according to the guidelines. Molnupiravir works by inducing genetic errors, and the FDA has recommended against using it in people younger than 18 or those who are pregnant or likely to become pregnant.

For now, the drugs are only being used in patients at highest risk, because of their scarcity, Glatt said. Pfizer has said that under a federal contract, it expects to have courses of Paxlovid for just 180,000 patients in 2021, but enough for millions next year.

Israel received its first shipment of Paxlovid on Thursday as part of a deal with Pfizer to send about 100,0000 pills. Initial data suggest that it cuts the risk of hospitalization by nearly 90%; molnupiravir also appears effective but much less so, cutting risk of hospitalization or death by about 30%.

The drugs may not be widely available in the U.S. now, but in the coming weeks -- after holiday schedules return to normal -- supplies should improve, Glatt said. 

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