Why eagerly awaited COVID-19 antiviral pills are sitting on shelves

A pharmacist in Seoul shows boxes of Paxlovid, Pfizer's oral COVID-19 pills, Monday. Yonhap

Daily infections to peak at 270,000 in March

By Lee Hyo-jin

Thousands of COVID-19 antiviral pills are sitting on the shelves of pharmacies amid an unexpected shortage of demand for the tablets, which were hailed initially as a game changer in the battle against the pandemic.

The easy-to-use pills were much anticipated as the best treatment option for patients undergoing home treatment, preventing high-risk groups from falling into critical condition.

As of Feb. 17, 8,905 patients have been prescribed Paxlovid, Pfizer's oral COVID-19 pill, although enough doses for 22,935 people have been shipped to the country since Jan. 14. This is far below the government's expectation that the pills would be used by over 1,000 people daily.

Doctors say the government has been failing to use the pills effectively, due to their excessive age limit and complicated prescription process.

"The low prescription rate seems to be attributable to the excessively high age limit, along with low awareness among doctors and patients about the treatment option," said Chon Eun-mi, a respiratory disease professor at Ewha Womans Mokdong Hospital.

Initially, the use of Paxlovid was limited to elderly people aged 60 and over, as well as the immunocompromised. But following a lack of demand, the government lowered the age limit to 50 early this month, before lowering it again to 40 on Monday.

The tablets are now available to those in their 40s and 50s who are suffering from underlying diseases ― diabetes, hypertension, cardiovascular diseases, chronic kidney diseases, chronic lung diseases, cancer or obesity (defined as those with a body mass index of 30 or higher).

But Chon viewed the eligibility should be expanded further to include all patients aged 12 and above, as approved by the country's drug regulator.

A postal worker in southern Seoul's Dongjak District prepares to deliver medical kits to COVID-19 patients undergoing self-treatment, Tuesday. The kits, which include fever reducer, thermometer and oximeter, are provided only to members of high-risk groups. Yonhap

"The government should open up the pills to more of the population, and let the doctors decide whether to administer the drugs depending on the patient's health condition, not their age," she said.

She also pointed out that the complicated prescription process is delaying timely access to the tablets, which are recommended to be taken within five days of the onset of symptoms.

After testing positive on a PCR test, patients should go through a consultation with a doctor, and then wait for the pills to be delivered to their home by public health officials.

Many patients fail to complete this process within the five-day window, according to Chon.

"If used with the right strategy, this treatment could be the best defense against Omicron," she said, urging the government to make better use of Paxlovid.

The country added 99,573 new COVID-19 infection cases for Monday, raising the aggregated total to 2,157,734. The Korea Disease Control and Prevention Agency (KDCA) warned that daily caseloads may surge to as high as 270,000 in early March.

Despite the surging infections, however, the health ministry said the country may be entering the final stages of the pandemic.

"If we manage to maintain the current low fatality rate, we could be able to treat Omicron like other endemic diseases in the end," Park Hyang, a senior health official, said during a briefing on Tuesday.

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