The Perfect Enemy | Weak Demand For Covid Antivirals Dampens Roaring Sales
August 11, 2022
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Dwindling demand for Covid antivirals is poised to offset strong sales from the first half of 2022, according to health analytics firm Airfinity, as officials in the U.S. and around the world urge doctors to make better use of the lifesaving drugs as supplies go unused on shelves.

Key Facts

New deals for antiviral pills to treat Covid-19 are slowing down amid weak demand for the treatments, according to a new report from Airfinity published Monday, which cites public reports on deals, finances and drug demand.

Pfizer, which dominates the market, could be left with up to 70 million surplus courses of Paxlovid by the end of 2022, Airfinity warned, pointing to data showing the pharmaceutical giant has sold just 50 million courses of the 120 million it plans to make in 2022.

Airfinity said there are a number of factors dampening demand in countries like the U.S., including a lack of public awareness over the drugs’ availability and how to get it, unclear prescribing guidance and difficulty identifying suitable patients in time (they should be taken within five days of infection) due to inadequate testing.

Merck, which was first to market with its antiviral pill molnupiravir (marketed as Lagevrio), faces an even gloomier prognosis, Airfinity said, and the company will likely struggle to sign any new deals in light of a superior competitor—Merck’s pill cuts the risk of hospitalization by around 30%, compared to 89% for Paxlovid—on the market.

Demand for Merck’s pill is just half of the 30 million courses it expects to produce this year, Airfinity said.

Harry Cheeld, Airfinity’s Covid-19 treatments analyst, said the data firm expects Pfizer to “dominate the market,” but expects sales to be held back by “poor uptake” in many countries that means stocks are unlikely to run low in 2022.


Despite the downturn, Paxlovid is still on track to be one of the bestselling drugs of the year—Airfinity estimates it will net $23.2 billion in revenue—and Airfinity said sales revenue rapidly increased from $1.5 billion in the first quarter to an estimated $9.3 billion in the second quarter, a 530% jump.

Big Number

$29.5 billion. That’s the total size of the global Covid antiviral pill market in 2022, Airfinity estimates. The vast majority of this, 79%, $23.2 billion, is expected to be from sales of Pfizer’s paxlovid. A fifth (20%) of the market comes from sales of Merck’s pill ($5.8 billion). The firm revised earlier estimates on revenue in 2022 down by 9%, which it said was primarily due to delays in the expected approval of another antiviral drug in Japan.

What To Watch For

A new treatment in Japan. Japanese authorities are considering approving a new antiviral pill to treat Covid-19. The drug, developed by Shionogi, has produced promising results from clinical trials and is expected to be approved this year.

Key Background

The development of oral antivirals was hailed as a gamechanger in efforts to combat Covid-19. They are designed to be taken at home before or shortly after symptoms developed and when taken correctly are effective at keeping high-risk patients out of the hospital. New evidence suggests the drugs are also effective at guarding against hospitalization and death in people with mild infections, a possible case for widening access. While early supply issues constrained use, these drugs are now in abundant supply in some wealthy countries, including the U.S. Confusion over side effects, skittish prescribing practices and lack of awareness over the drugs’ availability and efficacy mean they are often underused and supplies have languished on shelves to expire. Activist groups have accused Pfizer of profiteering on its Covid drug and vaccine over pricing and its refusal to waive patent protection.

Further Reading

Covid Patients Should Take An Antiviral Even If They Don’t Have Severe Symptoms, Study Finds (Forbes)

Paxlovid going underused due to doctors’ ‘misperceptions’, experts say (Guardian)

The Promising Treatment for Long COVID We’re Not Even Trying (The Atlantic)

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