UBC Faculty Research and Publications

Paxlovid in British Columbia Interim real-world analysis University of British Columbia. Therapeutics Initiative


Background: Therapeutics Letter 141 summarizes an interim analysis of the use of the antiviral medication Paxlovid (nirmatrelvir/ritonavir) in the Canadian province of British Columbia (BC). Paxlovid was authorized for emergency use by Health Canada in December 2021, in response to the COVID-19 pandemic. Methods: The Therapeutics Initiative’s (TI) Pharmacoepidemiology group examined the 28-day risk of Covid-19-related hospitalization or death from any cause using BC Ministry of Health datasets including PharmaNet, emergency department encounters, physician billing codes, discharge abstracts, PCR testing, and vaccination status. Patient follow-up data collected by community pharmacists was also assessed. Results: The review found that the evidence on Paxlovid is limited and of low certainty, due to issues with study design, conduct, and reporting. The available evidence suggests Paxlovid may reduce risk of hospitalization and death in some high-risk patients with COVID-19, but that the magnitude of this effect is uncertain and may be irrelevant to BC patients in 2023. Conclusions: The use of Paxlovid in BC should be guided by a careful consideration of the available evidence. Benefits have not been proven for lower-risk patients. PharmaCare’s program to record adverse drug events may lead to better methods of documentation in the future.

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