Covid-19 antiviral pill to be rolled out at selected polyclinics, clinics

Paxlovid, a new antiviral pill for treating Covid-19, will be rolled out at selected polyclinics and Public Health Preparedness Clinics (PHPCs) in phases to reduce patients' likelihood of hospitalisation.

This is the first Covid-19 pill approved by the Health Sciences Authority (HSA) for use here.

HSA noted that Pfizer's clinical studies showed there were few instances of side effects.

Currently, Covid-19 treatment in the community setting is given based on symptoms such as cough, fever and sore throat.

The Ministry of Health (MOH) told The Straits Times yesterday that patients at polyclinics and PHPCs who are at risk of severe Covid-19 and within five days of the onset of illness will be eligible for the drug.

It did not specify when the drug will be rolled out.

Eligible patients at both public and private hospitals who are at highest risk of severe illness can also receive the drug.

The drug has to be taken twice daily for five days, and should be given as soon as possible within five days of the onset of symptoms.

MOH said it will fully cover the cost of Paxlovid for use in eligible primary care settings for a limited period.

It cost the United States government about US$530 (S$720) for a five-day course.

MOH added: "The main intention is to reduce the likelihood of high-risk patients developing severe Covid-19 and requiring hospital admission, particularly during this period when the number of cases currently hospitalised remains high and healthcare workers are still under significant pressure."

These include patients who are immunocompromised, elderly people, and those with active cancer and severe lung, heart or kidney disease.

The National Centre for Infectious Diseases (NCID) told ST that it began administering Paxlovid to a handful of patients two weeks ago, and that the drug is already being used in acute hospitals.

MOH said there are strict guidelines governing its use.

It has worked with NCID to put in place monitoring processes to ensure that the drug is prescribed in accordance with prevailing guidance.

HSA said on Feb 3 that it has reviewed available clinical data and found that the drug could reduce Covid-19-related hospitalisation or death by 88.9 per cent when given within three days of the onset of symptoms.

The efficacy rate was 87.8 per cent when given within five days of symptoms appearing.

HSA also noted during Pfizer's clinical study that there were few instances of side effects.

Common side effects reported were mild to moderate, such as an altered sense of taste, diarrhoea, vomiting, hypertension, muscle pain and chills.

In Britain, the government's medical guidance advises that patients hospitalised for Covid-19 be first offered Paxlovid, followed by antiviral drug remdesivir if Paxlovid is unsuitable.

Paxlovid is also the recommended first-line treatment for eligible Covid-19 patients in the community.

It was approved in Britain in December last year.

Canada cleared the drug for use in January.

Another antiviral pill, molnupiravir, is currently being assessed by HSA for use here.

MOH had earlier signed a supply agreement with MSD Pharma - known as Merck in the US and Canada - to purchase the drug.

The drug is also targeted at those who are at risk of developing severe illness, and is said to be most effective when given early in the course of infection.

However, the Institute for Clinical and Economic Review, a US-based drug pricing research organisation, said that in clinical trials, molnupiravir was able to reduce hospitalisation or death by only 30 per cent.

The US Food and Drug Administration has said that while Merck's experimental Covid-19 antiviral pill appears effective, it may pose risks for pregnant women, including birth defects and toxicity to developing foetuses.