New study shows Pfizer’s Paxlovid offers no significant benefit for vaccinated high-risk adults, raising questions about billions in federal spending

• A major new study published in the New England Journal of Medicine found Paxlovid did not reduce hospitalization or death among vaccinated high-risk adults, with hospitalization rates under 1% in both treatment and control groups.
• The combined PANORAMIC and CanTreatCOVID trials involving over 4,200 participants showed no statistically significant benefit for the antiviral in populations with existing immunity.
• The U.S. government purchased nearly 24 million treatment courses at approximately $530 each, representing over $12 billion in taxpayer investment.
• Critics have questioned the nearly two-year delay in publishing results and whether financial motives influenced federal decision-making.
• Pfizer reported $18.9 billion in Paxlovid revenue in 2022 alone, with continued sales of $5.7 billion in 2024 and nearly $2.4 billion in 2025.

The study that changed the narrative

In a development that reshapes the understanding of COVID-19 treatment effectiveness, two large-scale clinical trials published on April 22 in the New England Journal of Medicine have found that Pfizer’s antiviral Paxlovid provides no statistically significant reduction in hospitalization or death for vaccinated adults at elevated risk of severe disease. The findings, emerging from the PANORAMIC trial in the United Kingdom and the CanTreatCOVID trial in Canada, involved 3,516 and 716 participants respectively, all of whom were at least 50 years old or 18-50 with coexisting medical conditions.

The studies were conducted between December 2021 and September 2024, spanning a period when most adults had acquired some degree of immunity through vaccination, prior infection, or both. The results showed hospitalization or death rates of 0.8% in the treatment group versus 0.7% in the usual-care group in the U.K. trial, and 0.6% versus 1.2% in the Canadian trial — differences that researchers deemed statistically non-significant.

What the data actually showed

The primary outcome measured was hospitalization or death from any cause within 28 days after randomization. In the PANORAMIC trial, 14 of 1,698 participants receiving Paxlovid were hospitalized or died compared to 11 of 1,673 receiving usual care alone. The adjusted odds ratio of 1.18 indicated a slightly higher risk in the treatment group, with a Bayesian probability of superiority at just 33.4%.

In the CanTreatCOVID trial, two of 343 Paxlovid recipients and four of 324 control participants were hospitalized or died, yielding an adjusted odds ratio of 0.48 — suggesting potential benefit but with wide confidence intervals that rendered the finding non-significant. The probability of superiority reached 83%, but researchers emphasized the results did not reach statistical significance.

Researchers stated plainly that they “found no evidence that early treatment reduced their already-low incidence of hospitalization or death in either trial and were unable to identify any prespecified subgroup with compelling evidence of treatment effect.”

The evolution of pandemic treatment

The significance of these findings must be understood against the backdrop of the pandemic’s evolution. In December 2021, Pfizer had announced initial study results suggesting Paxlovid reduced hospitalization and death risk by nearly 90% — a finding that drove the U.S. government to commit billions of dollars to procurement. However, those early results came from the EPIC-HR trial, which enrolled exclusively unvaccinated individuals at high risk during a period of different viral variants and no population-level immunity.

By the time the new trials were conducted, the landscape had fundamentally shifted. Widespread vaccination and natural infection had created a population with varying degrees of preexisting immunity. Anthony Fauci and Cliff Lane, writing in an accompanying editorial in the New England Journal of Medicine, acknowledged that earlier trials demonstrating strong benefits occurred “under different pandemic conditions, when fewer people had immunity and different variants were circulating.”

The editorial cautioned against overinterpreting the new data, suggesting clinicians might consider Paxlovid selectively for older or immunocompromised patients. The trials did find some benefit in symptom duration — recovery times shortened to 14 days from 21 days in the U.K. trial and to six days from nine days in the Canadian trial — but researchers noted these findings came from open-label trials without placebo controls, making them susceptible to subjective interpretation.

Financial questions and government investment

The financial dimensions of the Paxlovid story have drawn increasing scrutiny. The U.S. government purchased nearly 24 million treatment courses at an estimated $530 each, representing more than $12 billion in taxpayer funds. Pfizer reported record-breaking revenue of over $100 billion in 2022, including $18.9 billion from Paxlovid alone. The drug continued generating substantial revenue, with $5.7 billion in 2024 and nearly $2.4 billion in 2025.

The EPIC-SR trial, which evaluated Paxlovid in vaccinated high-risk and unvaccinated low-risk patients, ended early after showing no benefit — yet the Food and Drug Administration cited that trial in its full approval of the drug three years ago. Former FDA regulatory review officer Jessica Adams described the situation as “Epic Suppression of Results.”

Delayed publication and scientific integrity concerns

The nearly two-year gap between trial completion and publication has also generated controversy. The trials concluded approximately 19 months before publication, a delay that Venk Murthy, associate chief of cardiology for translational research at the University of Michigan, characterized as suspicious. The corresponding author did not respond to queries about the delay.

Cardiologist John Mandrola, writing in the Sensible Medicine newsletter, argued that the findings support the notion that “changing environments require new data” and that “trial results may often require an expiration date.” He noted that Paxlovid’s only clear benefit had been found early in the pandemic, before mass vaccination and infection, in Pfizer’s EPIC-HR trial. The difference with Paxlovid, he suggested, was “profit motive.”

A treatment in transition

The Paxlovid story illustrates the challenges of developing and deploying medical interventions during a rapidly evolving pandemic. What worked for unvaccinated high-risk individuals in late 2021 may offer little benefit to vaccinated populations with existing immunity in 2026. The drug demonstrated some value in reducing symptom duration, and an accompanying editorial suggested continued selective use for older or immunocompromised patients. But the core finding — that Paxlovid did not reduce hospitalization or death among vaccinated high-risk adults — cannot be dismissed. As researchers continue to analyze evolving data, the latest findings contribute to ongoing discussions about how COVID-19 treatments should be evaluated and deployed in populations with changing risk profiles and existing immunity. The question of whether the massive federal investment was justified will likely persist as a matter of scientific and financial debate for years to come.

Sources for this article include:

YourNews.com

NEJM.org

JustTheNews.com