Why Paxlovid's Failure is Bigger Than Paxlovid
“Paxlovid Failed!” screams one Substacker.
“Paxlovid Fails Again!” says a podcaster.
[Cue: confetti, dancing, chants of OLÉ! OLÉ!]
“Paxlovid Stinks—And It’s Racist!”
Okay, the last one isn’t real. But it’s hard to deny the unselfconscious glee that bloggers and Substackers (like me!) have shown as the daily train wreck of Paxlovid study results roll in. On Friday there was more elation when the Paxlovid Long Covid trial was published (it failed like all the others). So what exactly is driving this acute, collective Schadenfreude?
A quick list:
Doctors Were Bypassed: The FDA gave an ‘emergency use authorization’ to Paxlovid in December 2021 based on unpublished data. Mass media fluffed, and the company advertised for months, causing enormous pressure to prescribe. This frustrated doctors who couldn’t see the data. And when, two months later, there was finally a public study report, it was suspiciously opaque and underwhelming—even as millions clamored for Paxlovid.
Paxlovid Represents Profits Over People: The first Paxlovid trial, claiming a benefit, took two months from trial completion to publication. But when Pfizer’s second, far more relevant trial failed miserably it was two full years before it was published. When the drug failed for Long Covid, it took a year. Meanwhile the New England Journal of Medicine, the mass media, and Pfizer basked in the glory of Paxlovid’s false ‘success’, racking up clicks, advertising revenue, and drug sales. In other words Paxlovid didn’t work and Pfizer knew it, but kept it hidden—for years—while they sold it to millions of people at $1,400 a pop. Brutal.
Paxlovid Exemplifies Politics Over Science: Evidence-based doctors know first-trial results for new drugs are commonly wrong, and reversed in later, more even-handed studies. As soon as Anthony Fauci, from a couch at the White House, triumphantly declared Remdesivir effective I called the findings an illusion (based on a close look at the data). We now know Remdesivir has zero important benefits. Similarly, in early 2022 multiple scientific writers surmised Paxlovid was a loser. Some put their reputations on the line, making the case publicly. They were right and their logic was airtight, but health authorities ignored it. Paxlovid, which the Biden administration spent $10 billion on, shows how politics can derail and contaminate health policy and good medicine.
Mass Media Was Wrong, And Remains Unapologetic: I won’t link to the many articles fawning over Paxlovid, they’re ubiquitous. The Times, for example, continues (just last week) to hawk the drug. They wrote fluffy pieces about the drug’s first trial in 2022, praised it again in 2023, and in 2024 aggressively claimed doctors were costing lives by not using it more. And now, predictably, they’ve done no reportage on the April study showing Paxlovid is completely ineffective. Scientifically sound writers on Substack (Prasad, Demasi, Bivens, Faust, me, and others) are the only voices trying to dial back this pricey and harmful drug, and we are tiny compared to mass media. Paxlovid is a poster child for mass media dysfunction, disinformation, and self-service.
Retrospective Studies Are Unreliable: The recent Times article quoted retrospective studies claiming Paxlovid was associated with better outcomes. But the second Paxlovid study proves they were wrong (read here for why). Yet retrospective studies are still constantly cited, most recently to support the COVID vaccine. Most people do not realize that other than the few big, famous trials virtually every vaccine study is retrospective, and they’ve all been outed as hopelessly biased (in favor of the vaccines). The Paxlovid data reinforces this. The question of whether the vaccines were, overall, beneficial is shockingly complicated, but the best answers lie in the trial data—which companies like Pfizer and Moderna still refuse to give scientists access to. Hiding data during a once-a-century pandemic is breathtaking, but the point is that Paxlovid is a crucial reminder of how retrospective studies mislead, and how we need to see the trial data.
That’s enough for now, though there are more reasons. Just please know that no one is rooting against finding effective treatments. But disrespecting scientists, subjugating truth to money and politics, media self-service, and misleading with bad data, are mistakes we must recognize to fix. For that, and that alone, Paxlovid could still be highly effective.
👏👏👏 PREACH