NEW YORK (BLOOMBERG) - Demand for Covid-19 pills is set to make Pfizer Inc's Paxlovid among the fastest-selling treatments of all time, with revenue of almost US$24 billion (S$32.89 billion) expected in 2022, according to a forecast from analytics group Airfinity Ltd.
Overall sales of Covid-19 pills are expected to hit US$32.5 billion this year, up from a previous estimate of US$19.5 billion, London-based Airfinity said on Friday (April 22).
Sales of pills from Merck & Co and Shionogi & Co are also set to rise as cases increase and earlier treatments are rendered ineffective by new variants.
After slow initial uptake, demand for the pills is expected to surge as monoclonal antibodies lose potency.
Meanwhile, Omicron and its sub-variants such as BA.2 continue to spread, and demand for vaccines has been falling.
Wealthy countries led by the US, UK and Europe are driving the pill purchases, while large parts of the world wait for generic versions.
Reduced Covid-19 testing, confusion as to who's eligible for treatment, production constraints, falling hospitalisation rates and the perception of the Omicron variant as less virulent could limit the market's growth.
All those factors have led to an unexpectedly weak roll-out so far, Airfinity analyst Arsalan Azad wrote in a statement.
In parts of the US, for instance, the supplies have arrived, but use has been lower than anticipated.
Paxlovid's interactions with a number of common medications, some of those taken by older patients at high risk, are complicating the effort.
"There's a high chance if you prescribe it to a high-risk, Covid-positive patient, they're going to be on something," said Mr Philip Almeter, chief pharmacist at the University of Kentucky HealthCare.
Beth Israel Lahey Health, one of the two biggest networks in the Boston area, has adequate Paxlovid to treat patients and isn't seeing the need to restrict use, according to a spokesperson.
Covid-19 pills are cheaper and easier to administer than other treatments, their efficacy is holding up against variants and they should play a critical role as the Covid-19 pandemic moves to a more predictable endemic phase, Mr Azad said.
In contrast to the antiviral forecast, Airfinity has slashed its 2022 vaccine revenue estimate to about US$64 billion from US$81 billion.
The US government is rapidly moving Paxlovid to pharmacies, hospitals, nursing homes and other facilities and working to make sure doctors and patients know about the drug, but will need more funds to sustain the campaign, White House spokeswoman Karine Jean-Pierre said on Thursday.
If a requested US$10 billion is authorised, roughly half it will go to finalising an order of 20 million courses of Pfizer's Paxlovid.
The US has only paid for about 11 million of the courses, officials have said, and the rest will cost nearly US$5 billion.
Pfizer's drug could record US$23.6 billion in 2022 revenue, Airfinity said.
The average estimate of analysts surveyed by Bloomberg is US$26.9 billion.
While three dozen drug-makers will produce low-cost versions of the pill as part of an effort to expand supplies in lower-income regions, larger quantities aren't expected to reach the market until next year.
In endorsing Paxlovid on Thursday for patients who are most at risk, the World Health Organisation (WHO) expressed concern that low- and middle-income countries that were earlier left behind with vaccine purchases will again be pushed to the end of the queue.
Richer countries have purchased about two-thirds of all the Covid-19 pills that have been sold to date, according to Airfinity.
Merck's therapy could post US$6.4 billion in yearly sales, more than double the prior estimate, buoyed by regulatory approvals, Airfinity said.
Analysts surveyed by Bloomberg estimate US$5.82 billion.
Japanese drug-maker Shionogi's experimental treatment is forecast to generate US$2.5 billion in 2022 sales, according to Airfinity.
The US has held talks with Shionogi about buying its pill, people familiar with the matter said earlier this week, yet finding the money to pay for it could be a problem.
The drug, which is in late-stage clinical trials, reduced viral loads in patients within the first few days of use in earlier studies.