9 ms·

I think it’s hard to overstate what a big deal this is for science. This is a completely novel molecule that appears effective as an antiviral. This would a hug

I think it’s hard to overstate what a big deal this is for science. This is a completely novel molecule that appears effective as an antiviral. This would a huge achievement for the field of drug design, and will hopefully lead to all kinds of great medicine.

savant_penguin 5y ago
And it's here in _two_ years
- toyg 5y ago
  One one side: great job, pharma industry! We're gonna live forever! On the other side: what are you folks not curing, with your magic powers, just because you know you won't be able to make a buck from it...?
  - adminscoffee 5y ago
    this is where my mind was going, trying to remain positive and less conspiracy theory though. but it's really not secret that some companies (presumably pharmaceutical companies as well) have to stay in business and sometimes in order to do so, many companies build products that wear out, see how gillette razors came about for more insight on that
  - et2o 5y ago
    Researchers in pharma are working extremely hard and almost always in good faith. I know this is probably tongue-in-cheek but it's not true.
    - toyg 5y ago
      Yeah it's not really researchers that I'm worried about, it's their bosses.
      - bun_at_work 5y ago
        Can you provide an example of a treatment people would like that 'big pharma' wouldn't produce because they couldn't make a profit on it? This is such a ridiculous argument, IMO. As a thought experiment consider something like cancer treatment. If some pharma company researcher found a way to 100% prevent or reverse cancer, why would the company hide that? In the best case, they could make a ton of money from it by selling it cheap to everyone. In the worse case, they could make a ton of money selling it to the ultra wealthy with an obscene price tag. If they tried to hide it, the researcher would share the information elsewhere, no?
        rangoon626 5y ago
        The companies who make today's lengthy and expensive cancer treatments, are also making the mass-marketed personal care products that have carcinogens inside of them.
        raesene9 5y ago
        Whilst I don't buy the malice (big pharma deliberately not curing things they could) argument, there's plenty of things they don't do 'cause they don't think they'll make a profit on them. Novel drug research is extremely expensive and time consuming, logically speaking a for-profit pharma company will assign its resources to the research which is most likely to make a profit. As a result rare conditions will not attract the research necessary to create drugs to treat them. To give you a concrete example, AFAIK there was never a vaccine for MERS which is a coronovirus which preceded COVID-19.
        eganist 5y ago
        The practice is so widespread that the FDA had to create an incubator/accelerator to incentivize drug-making for rare conditions: https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/rare-diseases-program https://www.fda.gov/about-fda/center-drug-evaluation-and-res... And that's separate from the Office of Orphan Products Development: https://www.fda.gov/about-fda/office-clinical-policy-and-programs/office-orphan-products-development https://www.fda.gov/about-fda/office-clinical-policy-and-pro... It's not a recent thing, too. Different programs have been enacted in the US going as far back as the Orphan Drug Act of 1983. https://en.wikipedia.org/wiki/Orphan_Drug_Act_of_1983 https://en.wikipedia.org/wiki/Orphan_Drug_Act_of_1983 Broader reading: https://en.wikipedia.org/wiki/Orphan_drug https://en.wikipedia.org/wiki/Orphan_drug
    - dangerlibrary 5y ago
      Researchers need funding. The problem with "Big Pharma" is generally not with the intentions or capabilities of the researchers - it's with the funding.
    - ldehaan 5y ago
      Found the big pharma PR guy. The people in pharma are 100% not in this for the right reasons. Not one. Look into Every Single one of these companies just a tiny bit and you'll see how absolutely evil they are and by working for them you are complicit. You don't have to agree with reality, but that's reality.
      - et2o 5y ago
        You have a cartoonish view of reality.
      - GuB-42 5y ago
        People working in big pharma do it for money. But guess what, I work for money too, and it is the same for >99% of people. But most people appreciate it when as a side effect, their work save lives.
      - chefkoch 5y ago
        Huh, if all people working in pharma are complicit with big evil, what is your alternative? No one should work in pharma?
  - chadash 5y ago
    Unfortunately, it's expensive. The cost of R&D to bring a new drug to market is around $1 billion, and this doesn't include the cost of marketing (though it does include the cost of drugs that fail the approval process)(see https://jamanetwork.com/journals/jama/fullarticle/2762311 https://jamanetwork.com/journals/jama/fullarticle/2762311). At these numbers, it's hard to raise the money unless you think the drug is gonna be profitable.
    - noir_lord 5y ago
      On the one hand, yep absolutely. However on the other hand I look at https://en.wikipedia.org/wiki/HMS_Queen_Elizabeth_(R08) https://en.wikipedia.org/wiki/HMS_Queen_Elizabeth_(R08) which cost $4 billon to build. A billion is a lot of money but not for governments, it's kinda tragic when you look at what we spend on some things that we haven't figured out a more sensible way of allocating resources.
      - DanHulton 5y ago
        The problem, as it ever seems to be, is capitalism.
        todd8 5y ago
        What alternative to capitalism are you implying would be better? If you have a viable alternative, just do it yourself. (I’m not saying all by yourself, team up with others to make it happen.) I’m not being sarcastic, I’m genuinely interested in what you believe would get us from here to a Startrek-like economic system.
        angelzen 5y ago
        Startrek is amazingly devoid of status conflicts. Everybody takes for granted the the BigCaptain is BigCaptain for life and that the SeniorOfficers are SeniorOfficers for life. The crew is content to work routine boring jobs for years on end with exceedingly rare promotions (where to promote to other than a new ship?). Even in a society of small scale material affluence, there are scarce coveted goods, for example, being the captain of a starship.
  - thehappypm 5y ago
    Diseases like COVID are probably some of the easier ones to cure. It’s a foreign body that is tangible. We deeply understand how the virus replicates and how it works. We know which proteins and nucleosides to target. We don’t have that luxury for diseases like cancer, autoimmune diseases, and the like.
  - BurningFrog 5y ago
    If it was cheaper to bring a drug through the regulatory process, obviously more drugs would be produced. The cost explosion for these things are mainly the responsibility of US regulators.
  - kmeisthax 5y ago
    The second statement is equivalent to arguing that cut-throat capitalists aren't that cut-throat.
deleted 5y ago
[deleted]
GhettoComputers 5y ago
If unvaccinated people all died or went to the hospital it would be impressive, the title is misleading or lying about it’s effectiveness. The null hypothesis would probably neutralize it’s effectiveness. They don’t use infection prevention which would be much higher for unvaccinated because in reality it’s probably not very effective against COVID. The control we also don’t know any statistics about.
- comicjk 5y ago
  This is a placebo-controlled trial. The statistical comparison shown (85% fewer hospitalizations & deaths in the treatment group) already takes into account the non-hospitalized cases in the control group.
est31 5y ago
> This is a completely novel molecule that appears effective as an antiviral. This would a huge achievement for the field of drug design, and will hopefully lead to all kinds of great medicine. According to the Pfizer press release [0] Paxlovid uses Ritonavir [1], which is a known HIV antiviral, originally patented in 1989. At the start of the covid pandemic, chinese scientists even tried Kaletra, a generic that combines Ritonavir with another HIV antiviral, and found it to not improve outcomes [2], but this might have been due to them not giving the drug early enough in the infection, but only to hospitalized patients, while Pfizer gave it to non-hospitalized patients with a risk of later hospitalization. [0]: https://investors.pfizer.com/investor-news/press-release-details/2021/Pfizers-Novel-COVID-19-Oral-Antiviral-Treatment-Candidate-Reduced-Risk-of-Hospitalization-or-Death-by-89-in-Interim-Analysis-of-Phase-23-EPIC-HR-Study/default.aspx https://investors.pfizer.com/investor-news/press-release-det... [1]: https://en.wikipedia.org/wiki/Ritonavir https://en.wikipedia.org/wiki/Ritonavir [2]: https://doi.org/10.1056/NEJMoa2001282 https://doi.org/10.1056/NEJMoa2001282
- bvm 5y ago
  It's a combo regimen that includes ritonavir and PF-07321332 which does not have a generic name yet. Both are protease inhibitors.
  - est31 5y ago
    Oh thought that was some id name for ritonavir. Seems you are right: > PF-07321332 is designed to block the activity of the SARS-CoV-2-3CL protease, an enzyme that the coronavirus needs to replicate. Co-administration with a low dose of ritonavir helps slow the metabolism, or breakdown, of PF-07321332 in order for it to remain active in the body for longer periods of time at higher concentrations to help combat the virus. So the main job is done by PF-07321332 even, while ritonavir is only there to keep PF-07321332 a bit longer from being destroyed by the body.
- lekanwang 5y ago
  Yeah, as parent mentioned in another reply below, ritonavir is an antiviral, but has no effect on SARS-CoV-2 (https://pubmed.ncbi.nlm.nih.gov/34048671/ https://pubmed.ncbi.nlm.nih.gov/34048671/). Ritonavir is just used to inhibit CYP and therefore reducing clearance of the drug.
foolinaround 5y ago
> completely novel molecule Can someone please ELI5 what makes this unique from others?
- eganist 5y ago
  Reducing this quote mentioned elsewhere: > PF-07321332 is designed to block the activity of [a specific] enzyme that the coronavirus needs to replicate. Co-administration with a low dose of ritonavir helps slow [the breakdown] of PF-07321332 in order for it to remain active in the body for longer periods of time at higher concentrations to help combat the virus. It's a two-part drug. PF-07321332 is the new and shiny thing that impairs a crucial enzyme for the virus, while the pre-existing drug ritonavir lets PF-07321332 last longer, making it more clinically useful. That's my take on it.
- ldehaan 5y ago
  They can copyright it and make tons of money off of it is what it means. All of the other things that already work can't make them insane profits so, bought and paid for the news that you are fed tells you this is one of few valid ways to fight a virus you can dodge by staying in the sun for an hour each day and exercising your body.

savant_penguin 5y ago

And it's here in _two_ years

toyg 5y ago
One one side: great job, pharma industry! We're gonna live forever! On the other side: what are you folks not curing, with your magic powers, just because you know you won't be able to make a buck from it...?
- adminscoffee 5y ago
  this is where my mind was going, trying to remain positive and less conspiracy theory though. but it's really not secret that some companies (presumably pharmaceutical companies as well) have to stay in business and sometimes in order to do so, many companies build products that wear out, see how gillette razors came about for more insight on that
- et2o 5y ago
  Researchers in pharma are working extremely hard and almost always in good faith. I know this is probably tongue-in-cheek but it's not true.
  - toyg 5y ago
    Yeah it's not really researchers that I'm worried about, it's their bosses.
    - bun_at_work 5y ago
      Can you provide an example of a treatment people would like that 'big pharma' wouldn't produce because they couldn't make a profit on it? This is such a ridiculous argument, IMO. As a thought experiment consider something like cancer treatment. If some pharma company researcher found a way to 100% prevent or reverse cancer, why would the company hide that? In the best case, they could make a ton of money from it by selling it cheap to everyone. In the worse case, they could make a ton of money selling it to the ultra wealthy with an obscene price tag. If they tried to hide it, the researcher would share the information elsewhere, no?
      - rangoon626 5y ago
        The companies who make today's lengthy and expensive cancer treatments, are also making the mass-marketed personal care products that have carcinogens inside of them.
      - raesene9 5y ago
        Whilst I don't buy the malice (big pharma deliberately not curing things they could) argument, there's plenty of things they don't do 'cause they don't think they'll make a profit on them. Novel drug research is extremely expensive and time consuming, logically speaking a for-profit pharma company will assign its resources to the research which is most likely to make a profit. As a result rare conditions will not attract the research necessary to create drugs to treat them. To give you a concrete example, AFAIK there was never a vaccine for MERS which is a coronovirus which preceded COVID-19.
      - eganist 5y ago
        The practice is so widespread that the FDA had to create an incubator/accelerator to incentivize drug-making for rare conditions: https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/rare-diseases-program https://www.fda.gov/about-fda/center-drug-evaluation-and-res... And that's separate from the Office of Orphan Products Development: https://www.fda.gov/about-fda/office-clinical-policy-and-programs/office-orphan-products-development https://www.fda.gov/about-fda/office-clinical-policy-and-pro... It's not a recent thing, too. Different programs have been enacted in the US going as far back as the Orphan Drug Act of 1983. https://en.wikipedia.org/wiki/Orphan_Drug_Act_of_1983 https://en.wikipedia.org/wiki/Orphan_Drug_Act_of_1983 Broader reading: https://en.wikipedia.org/wiki/Orphan_drug https://en.wikipedia.org/wiki/Orphan_drug
  - dangerlibrary 5y ago
    Researchers need funding. The problem with "Big Pharma" is generally not with the intentions or capabilities of the researchers - it's with the funding.
  - ldehaan 5y ago
    Found the big pharma PR guy. The people in pharma are 100% not in this for the right reasons. Not one. Look into Every Single one of these companies just a tiny bit and you'll see how absolutely evil they are and by working for them you are complicit. You don't have to agree with reality, but that's reality.
    - et2o 5y ago
      You have a cartoonish view of reality.
    - GuB-42 5y ago
      People working in big pharma do it for money. But guess what, I work for money too, and it is the same for >99% of people. But most people appreciate it when as a side effect, their work save lives.
    - chefkoch 5y ago
      Huh, if all people working in pharma are complicit with big evil, what is your alternative? No one should work in pharma?
- chadash 5y ago
  Unfortunately, it's expensive. The cost of R&D to bring a new drug to market is around $1 billion, and this doesn't include the cost of marketing (though it does include the cost of drugs that fail the approval process)(see https://jamanetwork.com/journals/jama/fullarticle/2762311 https://jamanetwork.com/journals/jama/fullarticle/2762311). At these numbers, it's hard to raise the money unless you think the drug is gonna be profitable.
  - noir_lord 5y ago
    On the one hand, yep absolutely. However on the other hand I look at https://en.wikipedia.org/wiki/HMS_Queen_Elizabeth_(R08) https://en.wikipedia.org/wiki/HMS_Queen_Elizabeth_(R08) which cost $4 billon to build. A billion is a lot of money but not for governments, it's kinda tragic when you look at what we spend on some things that we haven't figured out a more sensible way of allocating resources.
    - DanHulton 5y ago
      The problem, as it ever seems to be, is capitalism.
      - todd8 5y ago
        What alternative to capitalism are you implying would be better? If you have a viable alternative, just do it yourself. (I’m not saying all by yourself, team up with others to make it happen.) I’m not being sarcastic, I’m genuinely interested in what you believe would get us from here to a Startrek-like economic system.
        angelzen 5y ago
        Startrek is amazingly devoid of status conflicts. Everybody takes for granted the the BigCaptain is BigCaptain for life and that the SeniorOfficers are SeniorOfficers for life. The crew is content to work routine boring jobs for years on end with exceedingly rare promotions (where to promote to other than a new ship?). Even in a society of small scale material affluence, there are scarce coveted goods, for example, being the captain of a starship.
- thehappypm 5y ago
  Diseases like COVID are probably some of the easier ones to cure. It’s a foreign body that is tangible. We deeply understand how the virus replicates and how it works. We know which proteins and nucleosides to target. We don’t have that luxury for diseases like cancer, autoimmune diseases, and the like.
- BurningFrog 5y ago
  If it was cheaper to bring a drug through the regulatory process, obviously more drugs would be produced. The cost explosion for these things are mainly the responsibility of US regulators.
- kmeisthax 5y ago
  The second statement is equivalent to arguing that cut-throat capitalists aren't that cut-throat.

deleted 5y ago

[deleted]

GhettoComputers 5y ago

If unvaccinated people all died or went to the hospital it would be impressive, the title is misleading or lying about it’s effectiveness. The null hypothesis would probably neutralize it’s effectiveness. They don’t use infection prevention which would be much higher for unvaccinated because in reality it’s probably not very effective against COVID. The control we also don’t know any statistics about.

comicjk 5y ago
This is a placebo-controlled trial. The statistical comparison shown (85% fewer hospitalizations & deaths in the treatment group) already takes into account the non-hospitalized cases in the control group.

est31 5y ago

> This is a completely novel molecule that appears effective as an antiviral. This would a huge achievement for the field of drug design, and will hopefully lead to all kinds of great medicine. According to the Pfizer press release [0] Paxlovid uses Ritonavir [1], which is a known HIV antiviral, originally patented in 1989. At the start of the covid pandemic, chinese scientists even tried Kaletra, a generic that combines Ritonavir with another HIV antiviral, and found it to not improve outcomes [2], but this might have been due to them not giving the drug early enough in the infection, but only to hospitalized patients, while Pfizer gave it to non-hospitalized patients with a risk of later hospitalization. [0]: https://investors.pfizer.com/investor-news/press-release-details/2021/Pfizers-Novel-COVID-19-Oral-Antiviral-Treatment-Candidate-Reduced-Risk-of-Hospitalization-or-Death-by-89-in-Interim-Analysis-of-Phase-23-EPIC-HR-Study/default.aspx https://investors.pfizer.com/investor-news/press-release-det... [1]: https://en.wikipedia.org/wiki/Ritonavir https://en.wikipedia.org/wiki/Ritonavir [2]: https://doi.org/10.1056/NEJMoa2001282 https://doi.org/10.1056/NEJMoa2001282

bvm 5y ago
It's a combo regimen that includes ritonavir and PF-07321332 which does not have a generic name yet. Both are protease inhibitors.
- est31 5y ago
  Oh thought that was some id name for ritonavir. Seems you are right: > PF-07321332 is designed to block the activity of the SARS-CoV-2-3CL protease, an enzyme that the coronavirus needs to replicate. Co-administration with a low dose of ritonavir helps slow the metabolism, or breakdown, of PF-07321332 in order for it to remain active in the body for longer periods of time at higher concentrations to help combat the virus. So the main job is done by PF-07321332 even, while ritonavir is only there to keep PF-07321332 a bit longer from being destroyed by the body.
lekanwang 5y ago
Yeah, as parent mentioned in another reply below, ritonavir is an antiviral, but has no effect on SARS-CoV-2 (https://pubmed.ncbi.nlm.nih.gov/34048671/ https://pubmed.ncbi.nlm.nih.gov/34048671/). Ritonavir is just used to inhibit CYP and therefore reducing clearance of the drug.

foolinaround 5y ago

> completely novel molecule Can someone please ELI5 what makes this unique from others?

eganist 5y ago
Reducing this quote mentioned elsewhere: > PF-07321332 is designed to block the activity of [a specific] enzyme that the coronavirus needs to replicate. Co-administration with a low dose of ritonavir helps slow [the breakdown] of PF-07321332 in order for it to remain active in the body for longer periods of time at higher concentrations to help combat the virus. It's a two-part drug. PF-07321332 is the new and shiny thing that impairs a crucial enzyme for the virus, while the pre-existing drug ritonavir lets PF-07321332 last longer, making it more clinically useful. That's my take on it.
ldehaan 5y ago
They can copyright it and make tons of money off of it is what it means. All of the other things that already work can't make them insane profits so, bought and paid for the news that you are fed tells you this is one of few valid ways to fight a virus you can dodge by staying in the sun for an hour each day and exercising your body.