This JAMA Viewpoint paper provides a summary of currently available therapeutics for nonhospitalized patients with COVID-19 in the setting of the Omicron variant including principles for equitable allocation. An operative paragraph
How Do Outpatient Therapies Compare?
Each of the new therapies has potential advantages and disadvantages (eTable 1 in the Supplement). For most individuals, nirmatrelvir-ritonavir will be preferred because of its higher efficacy and the convenience of oral dosing (eTable 2 in the Supplement). However, there will be circumstances in which nirmatrelvir-ritonavir should not be used because of serious drug interactions. In these patients, sotrovimab would be the preferred choice. If sotrovimab is not available, then remdesivir is a reasonable next option. The major advantage of remdesivir is a greater supply of the drug at this time; the main disadvantage is the need for intravenous infusion on 3 consecutive days. Remdesivir is particularly well-suited for use in a patient who is already in a health care setting, such as a skilled nursing facility, or in a person for whom home infusion services can be arranged. If none of the other options are accessible or appropriate, molnupiravir may be prescribed with the cautions summarized above.