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In 2021, nirmatrelvir/ritonavir clearly decreased hospitalization and death among COVID-19 patients who had high risks of severe disease and who had not been vaccinated or previously infected. It's a drug that saved lives, and would have saved many more if the vaccines had not beaten it to the punch.

The key thing to know is that nirmatrelvir/ritonavir's blockbuster effect was found in people who had neither been infected with SARS-CoV-2 nor vaccinated. But by the time it actually reached the open market, the vast majority of the high-risk U.S. population had already been infected or vaccinated. That immunity provides substantial long-term protection from severe COVID-19 when future infections occur, a fact which should not be minimized.

Well, we already found out this spring that nirmatrelvir/ritonavir is not as useful as it once was. Pfizer finally released results from its 2021-2022 trial showing that nirmatrelvir/ritonavir had no influence on symptoms among vaccinated patients with high risks or unvaccinated standard-risk patients. That study also found that hospitalizations were not statistically different across the nirmatrelvir/ritonavir and placebo groups but the study was not specifically designed to be definitive on that question.

But, we've been awaiting the results from a randomized controlled trial from the U.K. (the PANORAMIC study, which are expected to give key results on hospitalization and mortality for thousands of study participants. Head over to MedPage Today to read more about it.