Paxlovid is widely available, but information on who is taking it is rare



CNN

Paxlovid, an antiviral treatment for Covid-19, has been hailed as a game changer in the pandemic due to its strong work to reduce the risk of serious illness. Early delivery problems have been eliminated in the United States, and as vaccines are discontinued, the number of cases is increasing and infectious options are becoming more prevalent, making medicine more important than ever.

“Because there are no preventive measures and vaccinations are not increasing as fast as we would like and the number of people is not enough, it is our best thing to hospitalize or treat people at high risk of death. is a potential tool to reduce the impact of infection, ”he said. Andrew Pavia, an epidemiologist and infectious disease doctor at the University of Utah.

But the federal government has not shared any information Who is writing Paxlovid? Some experts fear that as Covid-19 continues to spread, those still at high risk may not be able to reach this next line of defense equally.

“We know that this pandemic highlights all the inequalities – all inequalities – in our health care system, and there is every reason to believe that access to this medicine will be the same as other issues related to this pandemic,” Pavia said. He is also a member of the National Institutes of Health’s Covid-19 Treatment Guidelines Panel.

“I think it’s important to know how Paxlovid is used and whether it reaches all the groups that need it equally.”

According to experts, the collection of demographic data in the health sector is always useful in order to make the system fair.

“I think if we look under the hood, as we found in the vaccine, we find disproportions,” said Steve Grapentin, a pediatric infectious disease pharmacist at the University of California, San Francisco and a member of the NIH panel.

“The only way we can make improvements and actually monitor the interventions we do is to measure it,” he said.

According to experts, there are several barriers inherent in Paxlovid that make this information especially important in this case.

Paxlovid works best when used within a few days after the onset of symptoms, but it requires a prescription and for some people it is more difficult to seek medical attention in a timely manner. Also, Paxlovid may interact negatively with other medications and have more complex prescription guidelines.

“It is possible that there are disproportions in the use of Paxlovid depending on people’s place of residence, income and race. But I think we need to be visible, “said Pavia.

The U.S. Department of Health and Human Services recently updated its Covid-19 therapy website to calculate the number of courses ordered and the number administered.

As of Thursday, about 831,000 Pakslovid courses had been scheduled – about 2.5 million courses ordered since the ambulance was approved in mid-December.

On closer inspection, some states (including Nevada, Washington, and New York) controlled much more than others (including South Dakota, Mississippi, and Alabama).

But apart from state-level results, there is no detailed demographic information on who Paxlovid is prescribed to – at least no one has been made public.

In a fact sheet released on Thursday, the White House administration said it had “called on all sites that produce oral antiviral drugs to collect reliable demographic data about people who have been prescribed COVID-19 therapists.”

“We are working with our pharmacy partners and health care providers to better understand who is taking these drugs,” an HHS spokesman told CNN. “This demographic data will improve our ability to identify any gaps in access in real time and help eliminate those gaps quickly.”

Major pharmacy vendors were integral in sharing information about vaccine intake early last year, and CNN contacted CVS and Walgreens to find out if similar efforts were being made to monitor Paxlovid intake. CVS said it was “obliged to provide federal officials with the demographic information they requested,” but did not share other details, and Walgrins said they were “in the early stages” of gathering information based on a recent request from the federal government. ”

Black, Hispanic, and American Indians were hospitalized with Covid-19 more than whites during the pandemic, but it is unclear whether people in these groups could actually receive treatment that would virtually reduce this risk. 90%.

According to the US Centers for Disease Control and Prevention, for the first time in recent months, the pandemic among Asians has been higher than in other racial or ethnic groups. However, there is no evidence that this treatment has spread to those communities.

The goal is to link the disease’s activity to “an increase in prescriptions if we need to do more to prevent people from being hospitalized,” Pavia said. “But to look at it, you need to know where the medicine was given compared to when the disease occurred.”

A senior health official in the Biden administration said states should report to the federal government on how many products are in inventory and how many are being distributed, but all government demographics now have anecdotal data.

The official said the government is working with states to ensure that treatment reaches the planned population. But CNN has contacted health departments in all 50 states to see if they have more demographic information about who Paxlovid is being subscribed to; More than half responded, but none of them had this information.

Some state health departments referred to local efforts to deliver Paxlovid to providers in poor service areas, while others suggested contacting providers directly for more information on who was taking the medication.

The California Department of Public Health notes that although there is “a lot of demographic and geographic information about who is getting Covid-19 vaccines in the state,” this does not apply to treatment.

In fact, states had immunization databases created long before the pandemic that allowed for centralized reporting of COVID-19 vaccinations. However, there is no register of prescription drugs, leaving scattered personal databases to providers as the only option to collect information on who is taking Paxlovid.

The Minnesota Department of Health said it is working with the state’s Electronic Health Record Consortium to begin collecting some of this information, but that any results are “unlikely to come true.”

With the expansion of the program and the Biden administration’s treatment trial initiative, the federal government says 9 out of 10 people in the United States live 5 miles from a site that actively distributes anti-virus programs such as Paxlovid. Covid-19 treatment. Another HHS website includes a map of thousands of places where Covid-19 treatment is available.

A new analysis by GoodRx, which monitors drug prices, found that Pakslovid’s distribution varied across the country, with some counties receiving no doses, while others received enough doses to treat all recently reported cases of Covid-19. Although rural districts were affected, the analysis showed that the distribution was fair, based on the racial and ethnic composition of the district, the level of poverty and other socio-demographic factors.

However, experts say that knowing where drugs are being distributed may lead to who they are targeting.

“It doesn’t tell you how it was released, it doesn’t tell patients how and to what patients it came,” Pavia said. Anonymous personal data can show “not just where the medicine is on the shelves or where the medicine got into the bloodstream when needed.”

Some work has been done to control the misuse of antibiotics and opioid prescriptions in this way, but experts say there is still much room for improvement.

“We need a strong infrastructure and information systems for electronic health records,” Grapentin said.

“I do not know that we know all the right interventions to eliminate the disparities, but at least if we have the data, we can see the progress in these interventions and reach our ultimate goal, which is to eliminate the health imbalances,” he said. to care”.

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