Expired Pfizer Covid antiviral drugs set to cost Europe €2bn

Millions of Paxlovid pills have gone unused as tight controls restrict access

A Pfizer manufacturing plant producing Paxlovid tablets for treating Covid-19. Photograph: Pfizer/EPA
A Pfizer manufacturing plant producing Paxlovid tablets for treating Covid-19. Photograph: Pfizer/EPA

More than a billion dollars worth of Pfizer’s Covid-19 antiviral drugs procured in Europe have been wasted, according to health data, as tight controls over who can receive the medication left millions of doses unused before their expiry date.

Paxlovid – designed to be given to patients shortly after they test positive for the virus – has been far easier to obtain in the United States than in Europe, where access has often been restricted to the elderly or people at high risk of developing severe Covid.

Data from analytics group Airfinity shows European countries including Britain, France, Spain and Italy could have made the medication more accessible without using up supplies, as more than 1.5 million five-day courses of the pill worth about $1.1 billion (€1 billion) have expired despite their usage dates being extended by six to 12 months.

By the end of February 2024, a total of about 3.1 million courses are set to expire, pushing the cost to European health systems to about $2.2 billion (€2 billion), according to Airfinity. The data does not include contracts that were EU-wide.

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Pfizer’s Irish plants in Newbridge and Ringaskiddy have been heavily involved in the manufacture of Paxlovid. The Cork plant makes the active ingredient for the medicine which is made into tablet form in Newbridge and other finishing plants across Europe.

The company announced 100 job losses at Newbridge last November as sales of Covid therapies fell sharply.

Marco Gallotta, an analyst at Airfinity, said some countries may have overpurchased Paxlovid when it became available at the end of 2021, just as the Omicron variant increased global caseloads.

“Governments were keen to buy the highly efficacious antiviral and had a difficult challenge of estimating demand with so many unknowns,” he said.

But a drop in cases and a sharp reduction in testing had hit the take-up of antiviral drugs, which needed to be taken shortly after the onset of symptoms, he said. “This means countries haven’t been able to administer all of their stockpiles before they expire, despite extensions to the shelf life.”

Pfizer said: “Expiry and destruction of doses can be an unavoidable consequence of a pandemic, a natural result of manufacturers and governments collectively aiming to address the public-health crisis at speed with the overarching objective of protecting their populations.”

There have also been concerns over how Paxlovid interacts with other common medications, which restricts how often it can be prescribed.

The European country with the biggest expiry rate is the UK, where an estimated one million doses worth $700 million were out of date by early December, the data shows. Another 550,000 doses are expected to expire in February, with a further 650,000 by the end of June.

The restrictions have been less stringent in other European countries, with elderly citizens and people with more common risk factors such as diabetes and obesity able to obtain the drug. Yet more than 200,000 Paxlovid courses expired before they could be used in Spain and about 100,000 each went out of date in France and Italy.

Even in the US – the largest market for Covid outpatient treatments – demand for Covid antivirals has fallen, tracking the reduced burden of Covid and a drop in testing for the virus.

About 5.3 million courses were prescribed in the US this year, 24 per cent down on 2022. The US government arranged with Pfizer to return 7.9 million Paxlovid courses at the end of 2023, at an estimated cost to the company of $4.2 billion. – Copyright The Financial Times Limited 2024