White House officials said Thursday they were introducing new models for the distribution of Paxlovid, the oral Covid-19 medication made by Pfizer, in an effort to get treatment to more people and keep coronavirus death rates relatively low. , even as cases increase.
The federal government will begin to reimburse a clinic in Providence, RI, for evaluating patients who test positive and immediately prescribe Paxlovid to those who qualify — the first of what the White House said would be a series of federally supported sites are set to open in New York and Illinois, with others. Federal workers are also being sent to state-run testing sites in Minnesota, transforming them into “test-to-treat” locations, the White House said.
“Basically, what we’re trying to do is get to a point where Covid deaths are largely preventable, and I think we’re pretty close to that,” Dr. Ashish K. Jha, the White House’s Covid-19 response coordinator, said in an interview Wednesday night. “Death from this disease really should be getting rarer.”
Significant barriers remain to getting Paxlovid to anyone who could benefit from it; according to data collected by the Department of Health and Human Services, more than a million government-purchased Paxlovid courses are still available. Due to vague authorization guidelines that are subject to wide interpretation – the medication is approved for people 12 years and older with “mild to moderate” Covid-19 who are at risk for serious illness – some doctors are hesitant to prescribe the pill, or extensively consultation needed.
As of Wednesday, the United States had an average of more than 110,000 new coronavirus cases per day, an increase of about 30 percent in the past two weeks, according to a DailyExpertNews database. But that’s considered a significant undercount, as Americans increasingly rely on at-home tests and their cases often go unreported. The number of new deaths has averaged less than 400 a day for the past two weeks.
dr. Jha attributed the more modest death rate to a combination of immunity conferred in part by vaccines, and the success of Paxlovid, which has been found to significantly reduce the chances of severe forms of Covid-19 in high-risk people when taken. started early in the course of the infection.
Federal health officials have continued to warn about the risks to particularly vulnerable people and beg older Americans to stay up to date on vaccinations. Last week, the CDC cited rising cases and hospitalizations as it strengthens its second booster recommendation for people 50 and older. But dr. Jha said the current gap between infection and death rates across the country was a promising moment in the pandemic, when Covid-19 could be less deadly.
dr. Jha said Northeastern states, places that already had higher vaccination rates, were using more Paxlovid, acknowledging that other places in the country might have different results. Conditions appear to be stabilizing in some northeastern states that have been among the first to see a spring wave in cases. While the numbers are still high, cases in New Jersey, New York and Rhode Island have started to level off or decline.
“What worries me is that as this virus spreads to other parts of the country that are both less stimulated and have used less Paxlovid to date – or this phenomenon that we’re seeing, of infections that don’t lead to many hospitalizations and deaths , whether that will hold up or not,” said Dr. yah.
Pharmacists still cannot self-prescribe the drug, a step that would shorten the time it takes patients to obtain the drug.
The Food and Drug Administration is “looking at this and thinking about it,” said Dr. yah. “Whether they are going to make a change, when and how, etc., is all in their wheelhouse.”
Many patients still perform the sometimes cumbersome steps themselves: finding a virus test, then getting a Paxlovid prescription from a healthcare provider, then finding a pharmacy that carries the pill, all within days of the first. symptoms.
dr. Jha described being frustrated by doctors’ colleagues who told him they still restrict Paxlovid to patients 65 and older.
Many locations in the government’s test-to-treat program are CVS MinuteClinics with in-house nurses and physician assistants who can prescribe the drug, a service that requires appointments and can be prohibitively expensive for those without health insurance.
Michael Ganio, the senior director of pharmacy practices and quality at the American Society of Health-System Pharmacists, said the test-to-treat system suffered from a lack of federal funding for Covid-19 care for the uninsured. He said that while the federally backed test-to-treat idea was limited in its scope, it could serve as an important example for state and local officials to implement similar programs.
“I don’t think it’s possible for the federal government to take enough of these measures to ensure equitable access across the country,” he said.
Still, with an increase in confirmed cases and greater awareness and availability of Paxlovid, prescriptions have exploded in recent weeks, with 25,000 to 30,000 written per day, said Dr. yah. More than 182,000 prescriptions for oral antiviral drugs were filled last week, the White House said in a press release on Thursday. Three hundred more locations now qualify as test-to-treat sites than they did a month ago, and nearly 40,000 pharmacies and other locations now have the antiviral pills.
Pharmacies can now also order Paxlovid directly from the federal government.
Without strict reporting requirements, the federal government struggles to understand who is getting Paxlovid, data that could be critical to knowing whether the most at-risk Americans, such as those in nursing homes, are getting the medication.
dr. Jha said federal officials should get a more detailed picture in the coming weeks of some of the groups tracking who has received the drug, from the Department of Veterans Affairs, Kaiser Permanente and certain hospital systems. Researchers are also looking into cases of symptoms that apparently bounce back after taking Paxlovid, he said.
“I hope we see a lot of data from some of these organizations in the coming weeks,” he said.
Mitch Smith and Chloe Reynolds reporting contributed.
