Biden Administration Beefs Up Access to COVID Antiviral Pills

The Biden administration plans to make Pfizer’s antiviral COVID pill nirmatrelvir-ritonavir (Paxlovid) more widely available at pharmacies and expand its so-called test-to-treat program, senior administration officials told reporters on Monday.

Under the new plan, the number of pharmacies with access to nirmatrelvir-ritonavir would double, as sites would be able to order the antiviral pill — which in trials reduced the risk of hospitalization or death by 90% — directly from the federal government.

“These actions will help strengthen and further build the infrastructure to ensure that life-saving treatments for COVID-19 are quickly distributed around the country, widely available, and easy to access,” a senior administration official said.

However, the official warned that “securing more and even better treatments will require additional funding from Congress.”

Oral antivirals for COVID-19 have been available since December and are currently available at roughly 20,000 locations around the country — including pharmacies, community health centers, and urgent care facilities. This will expand to 40,000 sites in the coming weeks, according to a press release from the administration, with 10,000 new locations having access immediately.

Intended for high-risk patients, more than 500,000 courses have been used to date, officials noted on the call, and usage has more than doubled over the last several weeks — from 22,000 to over 55,000 courses per week.

While initially hard to find, the antivirals are now in “ample supply” and the U.S. has committed to buying 20 million courses, the officials noted. Pharmacies will be able to continue to access treatments through state and territorial departments, as well as the administration’s 2,200 federally supported test-to-treat sites — which co-locate testing, assessment from a medical provider, and access to nirmatrelvir-ritonavir in pharmacies and other clinical settings.

The administration said it plans to launch more test-to-treat sites and to determine how best to expand them if needed during any potential surges in the future. “These sites will be targeted to meet demand and increase equitable access,” an official noted.

In addition to expanding access, the administration aims to provide clinicians with more guidance on these treatments, “including their benefits, contraindications, drug-to drug interactions, and other side effects.” The administration has been offering webinars with state and territorial health officials to help educate clinicians, and the CDC on Monday issued a health advisory on the availability and efficacy of these treatments.

Officials on the call stressed that initially providers were practicing with a “scarcity mindset” and only prescribing the treatment to “the sickest of the sick.”

But the treatment is now available and accessible for any patient “at high risk for progression to severe COVID-19,” per the FDA’s emergency use authorization, they said. This can include adults and children over the age of 12 with diabetes, cardiovascular disease, obesity, or other conditions. Some estimates suggest up to 60% of adults may meet criteria for a prescription, according to one of the officials.

The administration is also calling on electronic health record (EHR) companies to “develop and disseminate” information about COVID-19 therapies into their EHR interfaces to help make prescribing routine.

Finally, the administration plans to raise awareness among the general public about the safety and efficacy of oral antivirals, with an educational campaign that stresses the importance of receiving the treatments within the first 5 days of symptoms. The new efforts build on previous tools such as the launch of COVID.gov, which includes a test-to-treat locator and a call center that provides support in over 150 languages.