According to people familiar with the agreement, the Biden administration plans to pay more than $5 billion for a stock of Pfizer's new Covid-19 pill, enough for 10 million courses of treatment to be delivered in the next 10 months.
Senior federal health officials believe the drug will be a powerful weapon. The drug reduced the risk of hospitalization and death when it was given to high-risk unvaccinated people who developed symptoms of the disease.
Pfizer applied for federal authorization of the drug on Tuesday. The pill could be authorized as early as December, meaning that there could be a shortage of supplies in weeks. Pfizer requires 30 pills over five days, while Merck requires 40 pills over five days.
The hope that the United States will be able to curb the devastating toll from the Delta variant has been inspired by the antiviral drugs. More than four out of five Americans are at least partly vaccined, which is why experts think the worst of the coronaviruses has passed in the country.
Some say that the rates of infections have stopped and could easily rebound, especially with the start of winter. The daily average of cases has begun to rise after declining for more than a month. An analysis by the New York Times shows that the number of coronaviruses reported in the United States has increased by 18 percent in the past week. The number of deaths is down 15 percent to an average of 1,100 deaths a day.
The new oral antivirals will change the way Covid is managed, according to Dr. David Dowdy, an associate professor of epidemiology at the JohnsHopkinsBloomberg School of Public Health.
He said that the pills would help reduce the burden on hospitals and the death toll.
Covid has a new class of treatment called the antiviral drugs that is expected to reach far more patients than others have. Monoclonal antibody treatments can be given at outpatient clinics. Antiviral pills are meant to be taken at home.
Their promise depends on access to rapid over-the-counter tests, because the pills have proved to work in five days or less after symptoms develop. The government has pledged $3 billion for rapid tests, but they can be difficult to get, and a test can cost $12.
By the end of the year, the overall supply is projected to be ten times what it was in August, federal officials said.
Amesh A. Adalja is a senior scholar at the Center for Health Security.
Fast testing is going to be critical for the tests that are going to be used for the antivirals.
Availability is likely to be a much bigger obstacle. There will be enough courses to cover three million people before February. Pfizer is expected to be able to cover 300,000 people by the end of February.
The drug that appeared less effective in studies will be more plentiful. The Pfizer pill reduced the risk of hospitalization or death by 89 percent when given within three days after the start of symptoms. When given within five days of the start of symptoms, the pill was only 50 percent effective.
Both drugs are geared toward older people who have medical conditions that put them at higher risk of Covid. The data submitted by Pfizer shows the effectiveness of the treatment for people who are unvaccinated.
The Food and Drug Administration will decide which groups will be eligible to receive the treatments after Pfizer and Merck applied for authorization. The panel of experts that advises the FDA on antimicrobial drugs will meet at the end of the month to discuss the drug by Merck.
This is a new tool that can keep people alive and out of the hospital. The people who are going to get these are the people who can get diagnosed quickly and who are enough of a risk that someone might need to go to the hospital.
Over the next year, Pfizer and Merck plan to ramp up production. Pfizer expects to be able to produce enough pills to cover more than 21 million people by the first half of next year and 50 million by the end of the year.
Some of the supply has already been purchased by Australia and Britain. Pfizer said on Tuesday that it had reached an agreement to allow other manufacturers to make and sell the pills cheaply for use in 95 developing countries.
The initial plan was to order 1.7 million courses of Pfizer's treatment, with an additional option for 3.3 million, for $700 per course. The contract for 10 million treatments is expected to bring the cost down.
An announcement is expected this week on the contract.
