COVID-19 Oral Treatment to Be Limited to "Paxlovid"

KDCA to Exhaust Emergency-Use Drug "Lagevrio" Stock from the 17th of Next Month
Paxlovid-Contraindicated Patients to Be Guided to and Prescribed Veklury

The Korea Disease Control and Prevention Agency (KDCA) announced on the 26th that, going forward, it will limit the use of oral COVID-19 treatments to a single drug, Paxlovid.

On January 14, 2020, Paxlovid, an oral COVID-19 treatment, was delivered to a pharmacy in Guro-gu, Seoul. Photo by Kang Jinhyung

Until now, the three COVID-19 treatments supplied by the government have been the oral medications Paxlovid and Lagevrio, and the injectable Veklury. Paxlovid is used for mild to moderate cases among people aged 60 and older, patients with underlying conditions, and immunocompromised individuals. Patients for whom Paxlovid is contraindicated are treated with Lagevrio and Veklury.

Paxlovid and Veklury received marketing authorization and have been covered by the national health insurance system since October 25, 2024. In contrast, Lagevrio has not yet completed the marketing authorization process and remains under an "emergency use authorization" status.

Accordingly, the government has been supplying Lagevrio on a limited basis within the range of existing stock, but as the shelf life of that stock comes to an end, the use of Lagevrio is scheduled to be discontinued starting on the 17th of next month. Given the current COVID-19 epidemic situation, the government has not considered repurchasing the drug, and as a result, Paxlovid will be the only remaining oral treatment.

Patients who were previously eligible for Lagevrio can instead use Veklury, and primary care clinics must refer patients for whom Paxlovid is contraindicated to hospital-level or higher medical institutions where Veklury can be administered.

Meanwhile, in January this year, the Ministry of Food and Drug Safety expanded the approved indication of Paxlovid to include patients with severe renal impairment, including those on dialysis. As a result, even patients with severe renal impairment who were previously not recommended to use Paxlovid and were treated with Lagevrio can now receive Paxlovid with an adjusted dosage.

The government is preparing measures to improve prescribing convenience at frontline medical institutions so that the use of Paxlovid, which will become the only oral treatment, can be expanded. Paxlovid has as many as 40 contraindicated concomitant medications, and the need to check these drugs has been cited as a factor making it inconvenient to prescribe. In response, the KDCA plans to distribute a detailed guide to contraindicated concomitant medications, based on the product’s marketing authorization, in order to facilitate broader use of Paxlovid among patients who are taking such drugs.

Lim Seungkwan, Commissioner of the KDCA, said, "COVID-19 treatments remain an important means of effectively protecting high-risk groups," and urged, "Frontline medical institutions should actively consider prescribing Paxlovid and provide guidance on the use of Veklury."