Abstract: Clinical and Experimental Medicine (2023) 23:4033–4034
https://doi.org/10.1007/s10238-023-01010-7
CORRESPONDENCE
On the choice of Molnupiravir and Paxlovid as the only antivirals
permitted for COVID‑19 infection in Australia
Alberto Boretti1
Received: 14 January 2023 / Accepted: 23 January 2023 / Published online: 8 February 2023
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023
To the Editor,
Australia has prohibited to use the of COVID-19 antiviral therapies which were prohibited in Europe and North
America, despite countries permitting these therapies to
achieve much lower fatalities due to COVID-19 infection.
Then, in 2022, with COVID-19 starting to be downgraded
in many jurisdictions to the normal flu, with about the same
of flu fatalities, irrespective of vaccination status, Australia
finally permitted two antiviral drugs, which are not the more
effective, nor the cheaper in between those with trial information in the scientific literature, and only for selected categories (Fig. 1). The permitted oral treatment is Lagevrio
(Molnupiravir) and Paxlovid (nirmatrelvir and ritonavir).
According to the database of c19early.org [1], collecting all
the published data of all the trials about COVID-19 therapies, currently (January 2023) 36 of 48 treatments analyzed show statistically significant efficacy or harm, defined
as ≥ 10% decreased risk or > 0% increased risk from ≥ 3
studies. Paxlovid, listed since the second half of 2022, has
delivered so far an improvement of 40% based on 20 studies
including 26,783 patients. One treatment costs US$ 529. It
is ranked no. 20 for efficacy in All studies (pooled effects, all
stages). Molnupiravir, listed since the second half of 2021,
has delivered so far an improvement of 20% based on 25
studies including 69,837 patients. One treatment costs US$
707. It is ranked no. 41 for efficacy in All studies. Technically, at the time of approval in Australia [2], there was not
Fig. 1 Timeline of introduction
of COVID-19 therapies according to www.c19early.org [1].
Credit www.c19early.org
* Alberto Boretti
a.a.boretti@gmail.com
1
Johnsonville Road, Johnsonville, 6037 Wellington ,
New Zealand
13
Vol.:(0123456789)
4034
Clinical and Experimental Medicine (2023) 23:4033–4034
Fig. 2 Daily new COVID19 deaths per million people
according to www.ourworldin
data.org [3]. Credit www.ourwo
rldindata.org
enough data to support the use of Paxlovid. The Australian
government signed a contract with Merck Sharp & Dohme’s
(MSD) for the supply of Lagevrio, and with Pfizer for Paxlovid. The rank of c19study suffers from the time of the
introduction of one therapy, as the initial COVID-19 virus
was much less infectious but much more lethal than the latest
variants, of much-reduced lethality but increased infectivity,
as it was with the Spanish Flu, Fig. 2 [3]. The graph compares the fatalities in the United States and the United Arab
Emirates with the world average. The United Arab Emirates permitted since the beginning of the pandemic the use
of antiviral therapies which were otherwise obstructed in
the United States and Australia, also in the early stages of
infection [4, 5]. Therapies more recently introduced, such
as Molnupiravir and especially Paxlovid, are advantaged vs.
those introduced earlier. Why better performing therapies
were and are prevented, and why this selection, is a scientific
mystery. Should not the government follow science in the
selection of..
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