Stockpiles worth $1.1 billion of COVID-19 antiviral pill Paxlovid have expired in UK and Europe

Airfinity analysis reveals over 1.5 million courses of Pfizer’s COVID-19 antiviral drug Paxlovid expired unused in European countries by the end of November.

This number is forecast to reach 3.1 million courses expired by the end of Feb 2024, at a value of $2.2 billion.

The United Kingdom has seen the greatest unused stock with an estimated 1 million courses expired, at a cost of $700 million. With a further 550,000 more to expire by the end of February 2024 and a further 650,000 by the end of June 2024. Given the low prescription of Paxlovid in the country, 2.2 million courses could go unused by the end of June 2024, bringing the total drug value wasted in the UK to $1.5 billion.

Germany, France, Spain and Italy have all also seen wastage as prescriptions and uptake for the drug has been much lower across the continent than had been expected.

Pfizer’s Paxlovid first came to market at the beginning of 2022 as a critical tool in countries defence against COVID-19, especially for critically ill and immunocompromised patients, as clinical trial data showed a near 90% reduction in the risk of severe illness.

Many countries rushed to procure the drug just as the new Omicron variant emerged and caused an unprecedented surge in infections around the world.

Paxlovid generated sales of $19 billion in 2022 but this has declined sharply as uptake of the drug remained low. In October Pfizer said Paxlovid revenues would be approximately $1 billion this year, down 95% from 2022 results.

This decline would have been exacerbated by the United States, the largest buyer of Paxlovid accounting for 54% of reported sales to date, returning unused stock.

Despite the US having the highest uptake of the drug, the US government renegotiated its deal with Pfizer in October to return its stockpile of 7.9 million courses as the country transitions to the commercial sale of the treatment.

Airfinity’s Life Science Analyst Marco Gallotta says, “Governments were keen to buy the highly efficacious antiviral and had a difficult challenge of estimating demand at a critical stage in the pandemic. This doesn’t necessarily mean that higher uptake wasn’t desirable or could have saved lives and hospitalizations, but the reduction in testing has reduced demand.

Despite some countries like the US removing the requirement of a positive test when prescribing Paxlovid earlier this year, this drug is typically given upon a positive test.

Another driver is the llower disease burden in 2023, which of course means reduced demand for treatments. Together, all this means countries haven’t been able to administer all of their stockpiles before they expire, despite extensions to the shelf life of Paxlovid.”

To request more information about our methodology and uptake models, email us at infectiousdiseases@airfinity.com.