COVID-19 Oral Antivirals Expected to Generate USD 32.5 Billion in 2022


With the rise of more transmissible variants and the reduced efficacy of outpatient monoclonal antibody therapies, the market for oral antivirals is expected to climb to new heights this year. Pfizer to take the lead, followed by Merck, and possibly, Shionogi.

According to Airfinity’s recent COVID-19 treatment revenue forecast, the market for oral antivirals is expected to generate $32.5B in 2022, with $4.3B predicted in Q1, up approximately four times from 2021 Q4. Paxlovid is set to dominate the market with Pfizer to generate USD 23.6 billion and take 72% of total expected revenue.


Antiviral pills are going to play a vital role as the COVID-19 pandemic moves to endemic. The treatment is attractive to governments for many reasons. It is cheaper and easier to administer.

Dr Arsalan Azad, Airfinity’s Lead Analyst for Treatments


Oral antivirals to dominate outpatient treatment space in 2022

With Omicron seeing much larger global case rates than previously estimated, oral antivirals are expected to dominate outpatient treatment of COVID-19 this year. In addition, fewer monoclonals are due to occupy this space because they have proved largely ineffective against the Omicron variant. Government procurement of antiviral treatments is also set to remain strong with the majority of agreed supply deals still to be fulfilled, despite the limited access to testing and difficulties in reaching high-risk patients.



Pfizer, Merck, and … Shionogi

Pfizer’s Paxlovid may have started the year slowly, with sales in the first quarter of USD 1.6 billion, but sales are expected to increase throughout the year as production capacity grows.

Molnupiravir from Merck is set to generate $6.4bn this year, up from the previous forecast of $2.5bn. Resulting from the fulfilment of deliveries to the U.S. and several regulatory authorizations in other nations, significant growth is foreseen in the last quarter of 2022.

In addition, Shionogi’s antiviral, S-217622, is foreseen as becoming a contender as it gains several regulatory approvals in the second half of the year.



Revenues largely from high income countries

Nearly all Q1 revenue for Paxlovid and Molnupiravir is set to come from high income countries, with these countries currently accounting for over two-thirds of agreed antiviral supply deals and those still being finalised. Through the Medicine Patents Pool (MPP) agreement over a hundred lower and lower-to-middle income countries are expected to procure courses.


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