Hundreds of thousands of COVID-19 antivirals are on shelves across Canada
Health Canada has distributed enough of the antiviral Paxlovid to treat more than 700,000 people with COVID-19, but provinces have given only a fraction of the drug to patients.
Paxlovid has been shown to significantly reduce hospitalizations and deaths in people most at risk of COVID-19, such as the elderly and people with weakened immune systems. It is a combination of pills that can be obtained free with a prescription and taken at home, but must be started within five days of the onset of symptoms.
Research by CBC News finds provinces have distributed less than 15% of their Paxlovid supply since the drug was approved in January.
This low utilization rate means that hundreds of thousands of treatments are unused in Canada. It raises questions about why more people aren’t getting antivirals that could help them stay out of hospital, especially with health systems across the country under strain.
« I was one of the luckiest people »
Paxlovid is « incredible therapy, » said Dr. Zain Chagla, an infectious disease specialist who helps run a COVID-19 outpatient clinic at St. Joseph’s Hospital in Hamilton, Ont.
“There are certainly people hospitalized with COVID who unfortunately have not had access to this treatment,” he said in an interview.
“There is a bed shortage in emergency rooms, we know there is a bed shortage on the [hospital] neighborhoods. Anyone we can stop from landing in one of those health care beds…is a win for the system. »
A key concern raised by healthcare professionals interviewed by CBC News is that too many Canadians who could benefit from Paxlovid simply don’t know the drug is available.
Jim Catty, an 88-year-old Torontonian, had never heard of Paxlovid when he fell ill with COVID-19 in April.
« I had pain in every muscle in my body, » Catty said in an interview.
A home nurse caring for Catty’s wife for unrelated reasons knew Paxlovid. She contacted her doctor for a prescription.
« I was one of the luckiest people in that I was well taken care of, » Catty said. « I got my meds straight away and recovered pretty quickly. »
When Paxlovid was first approved, during the height of the Omicron wave of COVID-19, supply was limited and provinces placed strict limits on eligibility, making it unavailable to the vast majority of the population. .
More Canadians are now eligible for Paxlovid
Supply is no longer a problem. In addition to the 730,000 treatment courses already shipped, the federal government has purchased another 770,000 which will be distributed by the end of the year, according to a statement from the Public Health Agency of Canada.
Provincial health departments have since expanded their eligibility criteria, including as recently as last week when New Brunswick opened Paxlovid to « anyone at risk of serious consequences from the virus. »
Although details vary by province, Paxlovid is now generally available to most seniors, as well as adults with compromised immune systems who test positive for COVID-19. , including during a rapid test.
However, attendance remains low.
« Patients don’t know this is an applicable therapy, » Chagla said.
CBC News asked health officials in each province for data on their supply and use of Paxlovid. All but Ontario provided figures. Among the other nine provinces, approximately 13% of the treatments received from Health Canada were dispensed.
Prince Edward Island distributed the largest share among the provinces, 76%, while Newfoundland and Labrador distributed 27% of its supply.
British Columbia used about 12,000 of the 73,000 treatments it received
A spokesperson for the British Columbia Ministry of Health said in a statement that « this supply-to-use ratio does not necessarily reflect underuse or lack of access to treatment. »
The Ontario Ministry of Health did not respond to repeated requests from CBC News to provide usage data for Paxlovid.
Medications can be obtained at more than 4,000 pharmacies in Ontario, but people must first contact their doctor for prescriptions. This barrier has been lifted in five other provinces, including Quebec, where pharmacists can prescribe Paxlovid directly.
« It’s something that has really benefited a lot of patients, » Montreal pharmacist Daron Basmadjian said in an interview. « It’s really about getting the medicine to the person as quickly as possible so they can start it and have the best possible outcome. »
Elizabeth Leung, a clinical pharmacy specialist at Unity Health in Toronto, says all provinces should consider allowing pharmacists to prescribe Paxlovid to get patients started on treatment sooner.
Paxlovid « must be started within the first five days to have the best effect, and preferably within the first three days, » Leung said in an interview.
Calls to make more people aware of treatment
There are concerns that people who could benefit from Paxlovid are simply trying to get through their bouts of COVID-19 and end up waiting too long before seeking the treatment.
“It takes a lot from a patient perspective to be able to access it,” said infectious disease specialist Chagla. « They need to recognize they have symptoms. Patients may not know how to test, and ultimately they may not know who to call if they test positive. »
This prompts provinces to raise awareness about Paxlovid, in case fall and winter bring bigger waves of infection.
According to figures from the Public Health Agency of Canada, two-thirds of the more than 190,000 people hospitalized with COVID-19 across the country since the start of the pandemic were aged 60 and over.
A recent Israeli study published in the New England Journal of Medicine found significantly lower rates of hospitalization and death from COVID-19 in people aged 65 and over who received Paxlovid compared to those who did not. have not received any.
That same study found that the drug did not reduce COVID-related hospitalizations in healthy adults younger than 65.
Paxlovid is not for everyone. Antiviral therapy can interact negatively with other prescription medications, such as drugs for high blood pressure or high cholesterol. People are also advised to tell their healthcare provider if they have liver or kidney problems before taking Paxlovid.