8 ms·

> Pfizer used data on patients who were treated within three days of symptom onset as the headline finding in its press release > There were six hospitalizatio

by phh 5y ago

> Pfizer used data on patients who were treated within three days of symptom onset as the headline finding in its press release > There were six hospitalizations and no deaths among the 607 patients who received Paxlovid within five days of symptom onset, compared to 41 hospitalizations and 10 deaths in the placebo cohort. > Like Merck, Pfizer excluded people vaccinated against COVID-19 from its late-phase study. No pricing information. I'm worried that "3 days after symptoms onset" is too short to be usable in real-life, but I could be wrong.

nradov 5y ago
Monoclonal antibody treatments are also commonly administered about 3 days after symptoms onset. They have proven to be somewhat effective in real life, although they still aren't being given to some patients who could potentially benefit.
- apendleton 5y ago
  The monoclonal therapies are also administered by IV in a clinical setting, whereas this can be taken at home and could probably even be delivered. It should be even easier to make it within the three-day window with this treatment.
prepend 5y ago
If the cost is low enough and the side effects are mild enough it could work. People would take it before a test is positive so would end up taking it when they didn’t really need it. It’s similar to the antivirals for flu where you need to take it early on so it becomes habit to test early and start early. Home labs will help with this too. Where someone could take a test, get a prescription and pickup within a few hours.
- odyssey7 5y ago
  A useful comparison. I have never taken Tamiflu because I know I’d need to haul my weak, shivering, flu-infected self through public to see a doctor to get the Rx, go to the pharmacy… all for the personally-uncertain benefit of Tamiflu. Nowadays, this should be easier with so many virtual appointment options and delivery services. It should be, but is it? There should be an app that does all of it for you. 1. Scan your insurance card. 2. You get notified when a doctor is ready for your virtual visit. 3. If appropriate you get the Rx written. 4. That day, some delivery service will bring you the Rx. 5. Maybe a testing service stops by as well. Insurance companies should want to participate if it decreases Flu or Covid hospitalization for a reasonable cost. Anyone want to make this happen? My fall classes are nearly all finished. Edit: Pharmaceutical companies may wish to partner as well. Lots of avenues for this kind of service to find revenue.
  - curryst 5y ago
    There are a couple issues off the bat. 1. You're minimizing the 2 hardest parts of doing anything medical, which is the insurance billing and state licensing requirements. The state may consider you a medical services provider even if all you do is pair people with already-certified medical professionals. 2. "That day, some delivery service will bring you the Rx." This sounds illegal or heavily licensed/regulated. It's a drug addict's dream because it's so easy to maintain multiple identities. You probably get a random doctor, so the doctor won't notice it's you with a different name. And then they even send a driver to pick up the prescription, so the pharmacy won't notice that it's you with a different name. The pharmacy would also likely need to be in on it. I.e. in Texas, pharmacies that deliver are required to include any information that would have been given orally as a written document with the prescription. If the pharmacy doesn't know it's being delivered, they won't know to include those. If you wanted to partner with someone, it would be CVS or Walgreens, though. They already have licensed pharmacies everywhere, and handling the pharmacy requirements are going to be the hard part. I believe they also own a lot of those tiny clinic chains that are inside grocery stores, and this would give them a way to fill in any downtime in the nurses' schedules, as well as to let them soak up excess demand in one area with slack in another.
    - odyssey7 5y ago
      All important questions to figure out. Definitely not minimizing either of these two points. I have a lot more thoughts about this and everything you wrote that comes together compellingly as a nascent business strategy, and I’m not exactly naive in this domain. My first real software job focused on medical billing and insurance complexities in one of Epic’s two accounts receivables applications, but that’s really only the beginning of it. Happy to chat and discuss further. You can find my contact info in my profile. :-)
- toast0 5y ago
  > It’s similar to the antivirals for flu where you need to take it early on so it becomes habit to test early and start early. Are you actually able to get tests? I've brought my kid into urgent care and they won't test for flu, so it doesn't matter that there's a drug available, because they won't test.
adventured 5y ago
From the NY Times: "The U.S. government has been in negotiations with Pfizer for enough pills for 1.7 million courses of treatment, with an additional option for 3.3 million, according to a senior administration official. That is about the same quantity that the United States has ordered from Merck. The government expects to pay about $700 per treatment course for both drugs, the official said." https://www.nytimes.com/2021/11/05/health/pfizer-covid-pill.html https://www.nytimes.com/2021/11/05/health/pfizer-covid-pill....
exogenousdata 5y ago
Yahoo news[0] and other news sources report significant efficacy even at the 5 day mark. "Rates were similar for patients treated within five days of symptoms - 1% of the treatment group was hospitalized, compared with 6.7% for the placebo group, which included 10 deaths." [0] - https://finance.yahoo.com/news/pfizer-says-antiviral-pill-cuts-104500617.html https://finance.yahoo.com/news/pfizer-says-antiviral-pill-cu...
loceng 5y ago
Did they also check and exclude if they had natural immunity - COVID recovered, having antibodies?
ganzuul 5y ago
10 deaths with placebo... Medical ethics are confusing. Maybe this field needs more oversight. Especially on the corporate level.
- tsol 5y ago
  Patients enrolling in a clinical trial know they may get the placebo control. It wouldnt be more ethical to give it to all patients as in the case the medication does have a side effects you are only guaranteeing everyone gets hurt. As House put it-- >Just to shortcut this discussion.. People should not be testing drugs because they're desperate. But, people won't test drugs unless they're desperate. We need drugs to save children and puppies, ergo we need desperate people, ergo welfare kills sick children.
  - ganzuul 5y ago
    Has anybody said anything as insightful about preventative medicine?
- gonational 5y ago
  It's almost as if we could just let people make and live by their own medical decisions. We've got one case in recent history of an argument about "you're making decisions that affect me", and it turns out that this entire argument is bunk because the "vaccines" do not prevent the spread. So it's purely a personal decision about your own health. And pertaining to clinical trials, if I want to sign up for a clinical trial for a what might be a placebo for a great white shark bite in the midriff, that's my own choice. If I die because of this choice, that's my fault.

by phh 5y ago

nradov 5y ago

Monoclonal antibody treatments are also commonly administered about 3 days after symptoms onset. They have proven to be somewhat effective in real life, although they still aren't being given to some patients who could potentially benefit.

apendleton 5y ago
The monoclonal therapies are also administered by IV in a clinical setting, whereas this can be taken at home and could probably even be delivered. It should be even easier to make it within the three-day window with this treatment.

prepend 5y ago

If the cost is low enough and the side effects are mild enough it could work. People would take it before a test is positive so would end up taking it when they didn’t really need it. It’s similar to the antivirals for flu where you need to take it early on so it becomes habit to test early and start early. Home labs will help with this too. Where someone could take a test, get a prescription and pickup within a few hours.

odyssey7 5y ago
A useful comparison. I have never taken Tamiflu because I know I’d need to haul my weak, shivering, flu-infected self through public to see a doctor to get the Rx, go to the pharmacy… all for the personally-uncertain benefit of Tamiflu. Nowadays, this should be easier with so many virtual appointment options and delivery services. It should be, but is it? There should be an app that does all of it for you. 1. Scan your insurance card. 2. You get notified when a doctor is ready for your virtual visit. 3. If appropriate you get the Rx written. 4. That day, some delivery service will bring you the Rx. 5. Maybe a testing service stops by as well. Insurance companies should want to participate if it decreases Flu or Covid hospitalization for a reasonable cost. Anyone want to make this happen? My fall classes are nearly all finished. Edit: Pharmaceutical companies may wish to partner as well. Lots of avenues for this kind of service to find revenue.
- curryst 5y ago
  There are a couple issues off the bat. 1. You're minimizing the 2 hardest parts of doing anything medical, which is the insurance billing and state licensing requirements. The state may consider you a medical services provider even if all you do is pair people with already-certified medical professionals. 2. "That day, some delivery service will bring you the Rx." This sounds illegal or heavily licensed/regulated. It's a drug addict's dream because it's so easy to maintain multiple identities. You probably get a random doctor, so the doctor won't notice it's you with a different name. And then they even send a driver to pick up the prescription, so the pharmacy won't notice that it's you with a different name. The pharmacy would also likely need to be in on it. I.e. in Texas, pharmacies that deliver are required to include any information that would have been given orally as a written document with the prescription. If the pharmacy doesn't know it's being delivered, they won't know to include those. If you wanted to partner with someone, it would be CVS or Walgreens, though. They already have licensed pharmacies everywhere, and handling the pharmacy requirements are going to be the hard part. I believe they also own a lot of those tiny clinic chains that are inside grocery stores, and this would give them a way to fill in any downtime in the nurses' schedules, as well as to let them soak up excess demand in one area with slack in another.
  - odyssey7 5y ago
    All important questions to figure out. Definitely not minimizing either of these two points. I have a lot more thoughts about this and everything you wrote that comes together compellingly as a nascent business strategy, and I’m not exactly naive in this domain. My first real software job focused on medical billing and insurance complexities in one of Epic’s two accounts receivables applications, but that’s really only the beginning of it. Happy to chat and discuss further. You can find my contact info in my profile. :-)
toast0 5y ago
> It’s similar to the antivirals for flu where you need to take it early on so it becomes habit to test early and start early. Are you actually able to get tests? I've brought my kid into urgent care and they won't test for flu, so it doesn't matter that there's a drug available, because they won't test.

adventured 5y ago

From the NY Times: "The U.S. government has been in negotiations with Pfizer for enough pills for 1.7 million courses of treatment, with an additional option for 3.3 million, according to a senior administration official. That is about the same quantity that the United States has ordered from Merck. The government expects to pay about $700 per treatment course for both drugs, the official said." https://www.nytimes.com/2021/11/05/health/pfizer-covid-pill.html https://www.nytimes.com/2021/11/05/health/pfizer-covid-pill....

exogenousdata 5y ago

Yahoo news[0] and other news sources report significant efficacy even at the 5 day mark. "Rates were similar for patients treated within five days of symptoms - 1% of the treatment group was hospitalized, compared with 6.7% for the placebo group, which included 10 deaths." [0] - https://finance.yahoo.com/news/pfizer-says-antiviral-pill-cuts-104500617.html https://finance.yahoo.com/news/pfizer-says-antiviral-pill-cu...

loceng 5y ago

Did they also check and exclude if they had natural immunity - COVID recovered, having antibodies?

ganzuul 5y ago

10 deaths with placebo... Medical ethics are confusing. Maybe this field needs more oversight. Especially on the corporate level.

tsol 5y ago
Patients enrolling in a clinical trial know they may get the placebo control. It wouldnt be more ethical to give it to all patients as in the case the medication does have a side effects you are only guaranteeing everyone gets hurt. As House put it-- >Just to shortcut this discussion.. People should not be testing drugs because they're desperate. But, people won't test drugs unless they're desperate. We need drugs to save children and puppies, ergo we need desperate people, ergo welfare kills sick children.
- ganzuul 5y ago
  Has anybody said anything as insightful about preventative medicine?
gonational 5y ago
It's almost as if we could just let people make and live by their own medical decisions. We've got one case in recent history of an argument about "you're making decisions that affect me", and it turns out that this entire argument is bunk because the "vaccines" do not prevent the spread. So it's purely a personal decision about your own health. And pertaining to clinical trials, if I want to sign up for a clinical trial for a what might be a placebo for a great white shark bite in the midriff, that's my own choice. If I die because of this choice, that's my fault.