Global sales estimate for COVID-19 antiviral pills increased by 60% to $32.5bn

Posted on Apr 22, 2022

Airfinity has released its latest COVID-19 treatments revenue forecast for Q1 2022 and 2022. The forecast increases its total sales estimate for the year from $19.5bn to $32.5bn. 

The market for oral antivirals is predicted to have grown for the following reasons:

The higher transmissibility of Omicron has seen much higher global cases rates than previously estimated, creating a larger potential market for outpatient treatments.

Monoclonal antibodies, a previous outpatient treatment for COVID-19, have largely been shown to be ineffective against the Omicron variant and our analysis assumes fewer monoclonals to occupy this space.

Despite reduced access to testing and difficulties reaching high-risk patients, our data shows government procurement of antiviral treatments remains strong and the majority of agreed supply deals yet to be fulfilled. 

Today’s update includes Shionogi’s antiviral pill S-217622 which has entered the market and is expected to gain a flurry of regulatory approvals in the second half of the year.

Pfizer’s Paxlovid is predicted to dominate the market with sales of $23.6bn, taking 72% of the 2022 market. 

Our analysis expects a slow start for Paxlovid sales in the first quarter, $1.6bn, which will ramp up throughout the year. Production capacity is believed to have limited deliveries so far, with our data showing just over 5 million courses have been delivered to date, while the firm has booked sales of at least 42.3 million courses to be fulfilled this year. 

Merck’s Molnupiravir is forecast to generate $6.4bn this year, up from our previous forecast of $2.5bn. 

Airfinity estimates Merck will see significant sales growth from last quarter due to the fulfillment of deliveries to the U.S. and receiving a flurry of regulatory authorizations in other nations. Our analysis estimated Merck has delivered half of the 10 million courses it produced in 2021 generating $2.7bn in Q1 2022. 

Today’s analysis also shows that from publicly announced supply deals almost all of Q1 revenue for Paxlovid and Molnupiravir is expected to come from high income countries only.  High income countries currently account for over two-thirds of agreed antiviral supply deals and those still in talks. Over a hundred lower and lower middle income countries are expected to procure courses via the Medicine Patents Pool (MPP) agreement under which they can access cheaper generic versions of the treatment. Our forecast excludes any revenue which would potentially be generated from any MPP countries. 

Airfinity’s Lead Analyst for Treatments Dr Arsalan Azad says, “Antiviral pills are going to play a vital role as the COVID-19 pandemic moves to endemic. The treatment is attractive to governments for many reasons. It is cheaper and easier to administer. Its efficacy is not affected by evolving variants, they have a longer shelf life and can be stored at room temperature. 

“However, a rolling back of testing, patient confusion around eligibility and perception of the reduced virulence of Omicron has led to unexpectedly poor uptake. Despite this we expect to see more governments procuring these treatments with the potential to expand eligibility criteria to patients who are lower risk”. 

Download our COVID-19 Antiviral Forecast Report here.

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