New clinical trials and expert reactions raise concerns about the antiviral’s real-world impact despite billions in government spending.
By yourNEWS Media Newsroom
A newly published study in the New England Journal of Medicine has raised questions about the effectiveness of Pfizer’s COVID-19 antiviral Paxlovid in vaccinated adults at elevated risk, finding no significant reduction in hospitalization or death among those treated early in infection.
The findings come after the U.S. government committed substantial funding to the drug, including agreements outlined by Reuters, which reported billions in taxpayer support for procurement. Federal purchases ultimately reached nearly 24 million treatment courses, according to Pfizer, with each course estimated at about $530 based on prior analysis from PMC.
The study evaluated two large open-label trials — PANORAMIC in the United Kingdom and CanTreatCOVID in Canada — involving approximately 3,500 participants. According to a report by Just the News, researchers concluded that Paxlovid “did not reduce the incidence of hospitalization or death among vaccinated higher-risk participants” who had been symptomatic for five days or less.
“We found no evidence that early treatment reduced their already-low incidence of hospitalization or death in either trial and were unable to identify any prespecified subgroup with compelling evidence of treatment effect,” the study authors wrote.
The results align with earlier findings referenced by Just the News, which reported that Pfizer’s own research had previously cast doubt on the drug’s ability to address long COVID or significantly improve outcomes in certain populations. Additional reporting also highlighted concerns over rebound infections associated with the antiviral, including cases involving high-profile officials, as noted in coverage from Just the News.
Despite the findings, an accompanying editorial in the journal by Anthony Fauci and Cliff Lane cautioned against dismissing the drug entirely. They wrote that earlier trials demonstrating strong benefits occurred under different pandemic conditions, when fewer people had immunity and different variants were circulating.
“However, one should be cautious not to overinterpret the new data and conclude that nirmatrelvir–ritonavir is not of current value,” they wrote, suggesting clinicians may consider its use selectively, particularly for older or immunocompromised patients.
The trials themselves concluded roughly 19 months ago, but their delayed publication drew criticism from some observers. Venk Murthy reacted in a post on X, writing, “Nearly two years to publish this null finding!” while Jessica Adams described the situation as “Epic Suppression of Results” in her own post.
Further commentary questioned whether earlier regulatory decisions were justified. Adams referenced the EPIC-SR trial, which ended early and showed no benefit in vaccinated high-risk or unvaccinated low-risk individuals, yet was cited in federal decision-making, as discussed in Just the News reporting.
Some clinicians also raised questions about the broader rollout of the drug. Joseph Marine wrote in a post questioning whether government funds would be recovered, while noting in a separate post that the high-risk group in the study had less than a 1% hospitalization rate.
Other reactions included commentary from the Vaccine Safety Research Foundation, which criticized the broader handling of COVID-era pharmaceutical decisions, and an anonymous physician account that claimed prior warnings about the drug had been suppressed.
Cardiologist John Mandrola, writing in Sensible Medicine, said the findings support the idea that medical interventions must be reevaluated as conditions change. He noted that Paxlovid’s clearest benefit had been observed earlier in the pandemic, before widespread vaccination and prior infection altered population immunity.
The study did find some improvement in symptom duration, with recovery times shortened compared to no treatment. However, researchers noted these results were based on open-label trials without placebo controls, making them more susceptible to subjective interpretation.
Additional expert analysis from Jeffrey Morris in a post suggested that benefits may have been limited to unvaccinated individuals, citing slightly higher hospitalization rates in the treatment group compared to controls in the new trials.
The broader financial impact of Paxlovid has also drawn attention. According to Fierce Pharma, Pfizer recorded over $100 billion in revenue in 2022, including $18.9 billion attributed to Paxlovid. The company continued generating revenue from the drug, reporting $5.7 billion in 2024 and nearly $2.4 billion in 2025.
Meanwhile, research cited by Just the News suggested the virus had begun adapting around the treatment as early as 2022, prompting further scrutiny of its long-term effectiveness.
The drug’s trajectory has also included setbacks, such as Pfizer canceling a trial for a new COVID vaccine in certain age groups due to lack of interest, as reported by Just the News.
As researchers continue to analyze evolving data, the latest findings contribute to ongoing discussions about how COVID-19 treatments should be used in populations with existing immunity and changing risk profiles.
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