Public Health Impact of Paxlovid as Treatment for COVID-19, United States

Emerg Infect Dis. 2024 Feb;30(2):262-269. doi: 10.3201/eid3002.230835. Epub 2024 Jan 5.

Abstract

We evaluated the population-level benefits of expanding treatment with the antiviral drug Paxlovid (nirmatrelvir/ritonavir) in the United States for SARS-CoV-2 Omicron variant infections. Using a multiscale mathematical model, we found that treating 20% of symptomatic case-patients with Paxlovid over a period of 300 days beginning in January 2022 resulted in life and cost savings. In a low-transmission scenario (effective reproduction number of 1.2), this approach could avert 0.28 million (95% CI 0.03-0.59 million) hospitalizations and save US $56.95 billion (95% CI US $2.62-$122.63 billion). In a higher transmission scenario (effective reproduction number of 3), the benefits increase, potentially preventing 0.85 million (95% CI 0.36-1.38 million) hospitalizations and saving US $170.17 billion (95% CI US $60.49-$286.14 billion). Our findings suggest that timely and widespread use of Paxlovid could be an effective and economical approach to mitigate the effects of COVID-19.

Keywords: COVID-19; Paxlovid; SARS-CoV-2; SARS-CoV-2 transmission; United States; coronavirus disease; mathematical model; public health impact; respiratory infections; severe acute respiratory syndrome coronavirus 2; treatment; viruses; zoonoses.

MeSH terms

  • Antiviral Agents / therapeutic use
  • COVID-19*
  • Drug Combinations
  • Humans
  • Lactams*
  • Leucine*
  • Nitriles*
  • Proline*
  • Public Health*
  • Ritonavir*
  • SARS-CoV-2
  • United States / epidemiology

Substances

  • nirmatrelvir and ritonavir drug combination
  • Antiviral Agents
  • Ritonavir
  • Nitriles
  • Drug Combinations
  • Leucine
  • Proline
  • Lactams

Supplementary concepts

  • SARS-CoV-2 variants