Characteristics of outpatient nirmatrelvir/ritonavir recipients during the 2022/2023 era in Alberta, Canada: A retrospective observational population-based study.

BACKGROUND: An understanding of real-world nirmatrelvir/ritonavir (NMV-r; Paxlovid™) use in Canada is needed to inform strategies for therapy access and use. OBJECTIVE: To describe the characteristics of adults who received NMV-r in Alberta, Canada. METHODS: Population-level administrative data was used to describe adults (18 years and older) who received an outpatient dispensation of NMV-r between January 2022 and March 2023 in Alberta. Omicron variants predominated during this period. RESULTS: Mean age of the cohort (n=11,793) was 65 years (standard deviation=18), 60.4% were female and 83.9% had one or more health condition associated with a risk for the development of severe COVID-19 outcomes. In comparison to the general Alberta population, a larger proportion of those that received NMV-r resided in urban areas (Alberta: 82.3%; NMV-r: 89.8%) and were more socioeconomically well-off (Material Deprivation Index quintile 1-Alberta: 20.0%; NMV-r: 25.8%). A total of 81.6% received three or more COVID-19 vaccine doses and 7.0% received one or no dose. The majority of dispensed NMV-r prescriptions were from physicians (83.6%), with 13.5% from pharmacists and 2.9% from other healthcare providers. CONCLUSION: In Alberta, adults who received outpatient NMV-r displayed characteristics associated with risk for progression to severe COVID-19 outcomes (related to age and health conditions) and healthcare-seeking behaviour (older age, female sex, presence of health conditions, higher socioeconomic status and highly vaccinated). Provision by urban/rural and socioeconomic status were noted. Findings can be used to inform strategies for overcoming barriers and ensuring equitable access to COVID-19 therapy for all who are most likely to benefit.