The European Commission and pharmaceutical giant Pfizer that makes Paxlovid are in the process of negotiating the tender contract. While it has been suggested in the past that Paxlovid could reach Estonia this summer or fall, the Health Insurance Fund currently says it is difficult to predict when the drug might arrive. It has been suggested Pfizer is reluctant to guarantee delivery volumes, while the EU is less than enthusiastic about signing uncertain contracts.

The tender dragging on has raised the question of whether Estonia should have sought to secure Paxlovid direct from Pfizer. Healthcare officials say that attempting a solo act would not have yielded better results.

Maris Jesse, advisor to Minister of Health and Labor Peep Peterson, gave the coronavirus vaccine as a positive example. "We have the Covid vaccines example, and I can tell you we would have gotten them much later without a joint procurement," she suggested.

Estonia launched Covid immunization ahead of Japan as they lacked vaccines, Jesse pointed out. "The same logic applies when it comes to Covid medicines. The conditions are better as part of a joint tender than we would have as a small country trying to negotiate with major pharmaceutical companies," she said.

Maret Voore, advisor at the Ministry of Social Affairs' medicines department, said that a joint procurement helps resist "insensible conditions" companies might seek, such as very high prices or minimum orders.

Therefore, pooling the needs of tender participants, it is possible to achieve a lower unit price and sufficient quantities through a scale effect, Voore said.

She added that the European Commission has prohibited tender participants from seeking parallel independent negotiations as it might affect the outcome of the joint tender.

Paxlovid will not affect Covid classification

One reason people are so keen to see the drug arrive in Estonia is that healthcare officials have in the past suggested the availability of over-the-counter drugs is among the main criteria in terms of whether COVID-19 will be reclassified as an ordinary seasonal infectious disease. Once that happens, the government would not longer be able to order extensive Covid restrictions.

Deputy Director of the Health Board Ott Laius now said that Paxlovid's arrival in Estonia is not as decisive when determining the status of Covid. The virus' ability to cause serious illness that requires hospitalization plays a far bigger role, Laius suggested.

"Scientist believe that the current strain of the virus is less dangerous than its predecessors. Recent studies suggest every 30th adult in Estonia is infected with the virus, while the illness is much milder than before," the deputy director said.

"When the drugs reach pharmacies, they are primarily meant for patients belonging to risk groups. Other people are far less likely to require hospitalization due to Covid, though it is not impossible. That is why we cannot say right now that the drugs will be available to everyone in the near future and that we can reevaluate the disease's impact based on that," he added.

In addition to Paxlovid, Estonia is participating in a EU joint tender for another Covid medicine called Lagevrio that is still awaiting authorization for sale in the EU.

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