Pfizer's COVID Pill Could Be ‘Game Changer,' Boston Doctor Says

NBC10 Boston asked two top Boston doctors for their thoughts on what a COVID pill would mean

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Pfizer and other drug companies are currently testing pills that could treat COVID-19 and perhaps prevent outbreaks before cases can spread.

The drugmaker said Monday that it will study the pill it is developing in combination with a low dose of the HIV drug ritonavir in people who are at least 18 years old and live in the same household with someone who is infected.

Pfizer is also studying its potential treatment in people who are already infected with the virus. It’s designed to be prescribed at the first sign of infection without requiring patients to be hospitalized. The drugmaker expects to see results from those studies by the end of the year.

In a new weekly series, "COVID Q&A," NBC10 Boston asked two top Boston doctors on Tuesday for their thoughts on what a COVID pill could mean. Here's what they had to say:

How important a tool could a COVID pill be in the battle against the deadly virus?

"We definitely need more therapeutics and more prophylactic medication, and we need more oral options," said Dr. Shira Doron of Tufts Medical Center.

"Right now, in terms of preventative, we do have monoclonal antibodies that have been approved," she added. "If you get exposed, you can get an infusion to prevent infection. But it is exremely resource intensive to provide monoclonal antibody infusions. It's quite difficult."

"It would be super to have an oral agent that's well tolerated that works shortly after exposure to prevent somebody from becoming infected," Boston Medical Center's Dr. Davidson Hamer said. "It will be interesting to see how it works and whether it works."

So far, only one antiviral drug, remdesivir, has been approved to treat COVID. But it is given intravenously to patients ill enough to be hospitalized, and it isn’t intended for early, widespread use. By contrast, the top contenders under study can be packaged as pills.

"In general, when it comes to therapeutics, we don't have any oral therapeutics," Doron said. "We have remdesivir that has been shown to be effective in early disease, but it's really difficult, again, to give an intravenous medication to someone who doesn't yet require hospitalization."

Hamer said there has been a ton of attention given to the Pfizer drug, but it's too early to tell if it will work.

"There's certainly a lot of hype around it because it's an oral agent," he said. "But we need data to show that it's going to be effective in the ways they would like it to be."

Could this change how the virus is treated?

"At this point, most of the treatments we use happen in the second stage. That's because that's when you get hospitalized, when the virus is receding but inflammatory effects are increasing," Doron explained. "We really need to act and use our preventative and treatment options early so you never get to that second stage. I hope that over time over the next months we shift our treatment strategy to really focus on that early stage so we never get to that hospitalization stage."

"If you can bring that viral load down, it gives the immune system a better chance and the risk of deteriorating to severe disease is greatly reduced," added Hamer.

Why do we need a COVID pill if we already have effective vaccines?

"The challenge is we are seeing vaccine breakthroughs, so the vaccination is not 100% protective," Hamer said. "There's a need for treatment. A lot of people aren't vaccinated, in the U.S. and around the world. Having a treatment that will allow us to slow the progression of the disease or knock it out before the inflammatory response occures will be a very important game changer."

But he said other oral agents have been tried over the last year and a half, without success. So there needs to be substantial evidence before Pfizer's pill is used.

Could news of the pill deincentivize people from getting the vaccine?

"I'm always concerned about things that impact people's willingness to be vaccinated," Doron said. "This is yet another area where I think very good education is going to be important. If this turns out to be a useful strategy, then it's good to have and we just need to explain that you still don't want to get COVID because it's unpredictable how it will affect you, with or without the availability of a pill. It is unpredictable, especially compared to the incredible safety profile of vaccines."

"If it does work -- that's the first question -- are those people who were infected still at risk for long COVID?" Hamer asked. "If they are, you definitely want to avoid it altogether rather than having that small risk."

The Associated Press and NBC News contributed to this report.

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