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Characteristics of outpatient nirmatrelvir/ritonavir recipients during the 2022/2023 era in Alberta, Canada: A

Khanh Vu1, Jason Randall1, Karen Martins1

  • 1Real World Evidence Unit, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB.

Canada Communicable Disease Report = Releve Des Maladies Transmissibles Au Canada
|August 20, 2026
PubMed
Abstract

Insights

Nirmatrelvir/ritonavir (NMV-r) was prescribed to adults in Alberta, Canada, primarily those at high risk for severe COVID-19. Findings highlight demographic patterns and inform strategies for equitable access to this vital antiviral therapy.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Public Health

Background:

  • Real-world data on nirmatrelvir/ritonavir (NMV-r; Paxlovid™) use in Canada is crucial for optimizing therapy access and utilization.
  • Understanding patient profiles receiving NMV-r informs public health strategies for managing COVID-19.

Purpose of the Study:

  • To characterize adults who received outpatient nirmatrelvir/ritonavir (NMV-r) in Alberta, Canada.
  • To identify demographic and clinical factors associated with NMV-r prescription.

Main Methods:

  • Population-level administrative data from Alberta, Canada, was analyzed for outpatient NMV-r dispensations between January 2022 and March 2023.
  • The study included 11,793 adults aged 18 years and older, during a period dominated by Omicron variants.

Main Results:

  • The cohort (n=11,793) had a mean age of 65 years, with 60.4% being female. 83.9% had health conditions increasing risk for severe COVID-19.
  • Recipients were more likely to reside in urban areas (89.8%) and be socioeconomically well-off compared to the general population.
  • 81.6% received three or more vaccine doses, and prescriptions were predominantly from physicians (83.6%).

Conclusions:

  • Adults receiving NMV-r in Alberta exhibited characteristics of high risk for severe COVID-19 and proactive healthcare engagement.
  • Observed patterns in urban/rural and socioeconomic distribution suggest potential access disparities.
  • Findings support the development of strategies to overcome barriers and ensure equitable access to NMV-r for at-risk populations.
Keywords:
COVID-19Paxlovidadministrative dataobservationaloral antiviral therapyoutpatient usepopulation-basedreal-world

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