Medical entity warns of lack of access to medicines against Covid in Brazil

The SBI (Sociedade Brasileira de Infectologia) released this Wednesday (5) a note in which it expresses concerns about access to medicines used to treat Covid-19 in Brazil.

In the document, the entity cites five drugs that have already been approved by Anvisa for use in patients with viral infection, but which still face obstacles to being distributed in public health.

One of these drugs is paxlovid, approved for emergency use in March, but whose first 50,000 units were only received by the country last week. Even with the delivery, there are still distribution difficulties, SBI says. “To date, there has been no distribution of medication to the states of the federation.”

The entity says that the incorporation of the drug is important because it is indicated for mild and moderate cases in order to avoid the development of serious complications in patients at higher risk.

Another drug is baracitinib. Approved by Anvisa in September 2021, it is suggested for critically ill patients with supplemental oxygenation in order to prevent the condition from evolving into the need for ICU admission.

Regarding Brazil, the SBI criticizes the lack of transparency on how the drug is distributed to state health departments and to hospitals that treat severe cases of Covid-19.

The situation of molnupiravir in Brazil is another point raised by SBI. The drug is recommended for patients in the early stages of the disease. Studies have already shown that the drug is effective in stopping the progression to severe disease, reducing the risk of death and hospitalization.

However, Conitec (National Commission for the Incorporation of Technologies in the Unified Health System) —a body linked to the Ministry of Health— did not approve the incorporation of the treatment into the SUS, a point that is criticized by the SBI.

In a similar situation is remdesivir, a drug applied directly into the patient’s vein. Research has already demonstrated its effectiveness for mild, moderate and severe cases when non-invasive supplemental oxygenation occurs. Even so, Conitec chose not to incorporate the drug into the SUS.

“It is recommended that the decision not to incorporate remdesivir by Conitec be re-discussed, […] especially since important studies on this topic were published after this resolution [da Conitec]”, says the SBI.

The association of monoclonal antibodies tixagevimab and cilgavimab are the last ones mentioned by SBI in the published note. The treatment is effective in preventing symptomatic SARS-CoV-2 infections in patients at higher risk. Anvisa has already approved the use of the drug in Brazil.

In the case of SUS, Conitec chose, in June, not to incorporate the combination. A month later, the commission launched a consultation for the community to collaborate with information for a possible reconsideration of the decision taken.

After analyzing these contributions, the commission continued with the position of not recommending monoclonal antibodies, contrary to what the SBI advocated.

“The Brazilian Society of Infectious Diseases reiterates that it is in favor of the incorporation of cilgavimab + tixagevimab within the scope of the SUS, as it understands it to be a fundamental intervention in the prevention of infection by Sars-CoV-2 in individuals at high risk of progression to severe Covid-19 and with less effectiveness. vaccine”, concludes the entity in the note.