‘Game-changing’ Covid antiviral to be available in hospitals next week

A new pill that can prevent death from Covid-19 is being made available from next week, but only to hospital inpatients.

Paxlovid, hailed as a “game-changing” drug in the fight against the virus, will be used largely to treat older or at-risk unvaccinated patients along with the immuncompromised, the HSE confirmed last night.

The first 5,000 doses of Paxlovid, which can prevent death from Covid-19, arrived in Dublin on Wednesday, and information on its use was circulated to hospitals last night.

Paxlovid has been available on prescription in Northern Ireland and Britain since January, but its arrival in the Republic has been repeatedly delayed.

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“Paxlovid will begin to be available in hospitals from next week for inpatients, and following conclusion of a consultation process, through GPs in the community,” according to the HSE.

Consultations with GP groups on its use in the community are at “an advanced stage,” a spokeswoman said.

Separately, doctors have been advised not to prescribe the only newly developed Covid-19 treatment currently available because of its lack of effectiveness against the current variant.

Dr Colm Henry, chief clinical officer of the HSE, has told doctors the drug sotrovimab is "unlikely to be effective" against the BA.2 variant and that there is no evidence a higher dose would improve its efficacy.

Dr Henry’s advice on sotrovimab follows the approach taken by US authorities, where its emergency use authorisation has been removed in states where BA.2 accounts for more than half of cases. The strain accounts for virtually all cases in Ireland.

Switch to remdesivir

In the absence of other options, treating doctors have been told to switch to remdesivir for unvaccinated and some immunocompromised patients.

Use of sotrovimab has been largely restricted to unvaccinated and immunocompromised patients. The HSE said 2,000 doses of the drug had been supplied, of which 673 had been administered across all hospitals – roughly one in every thousand of the more than 700,000 PCR-confirmed cases so far this year.

Michael Rynne of Chronic Lymphocytic Leukaemia Ireland said vulnerable patients with blood cancers were struggling to access the treatment due to strict eligibility criteria. A patient with a positive PCR test has to contact a GP and be referred to a hospital, where a consultant decides if they are eligible for the drug.

A HSE spokeswoman said it had been working for several months to prepare for the availability of therapeutics for people with Covid-19. She said product availability was limited internationally and products were subject to regulatory review and approval for use.

GSK, which manufactures sotrovimab, said there was no issue with supply of the drug to Ireland.

Another new treatment, Evusheld, recently received authorisation in the EU and is available in France, Germany, Spain, Sweden, Austria and the Czech Republic, according to its maker AstraZeneca, but not in Ireland.

The Irish Cancer Society called for the earliest possible access for patients to Paxlovid and Evusheld, particularly in view of the "narrowing therapeutic window" offered by sotrovimab.