Will Paxlovid and Covid tablets reach those who need it the most?

Editor’s note: Find the latest COVID-19 news and instructions at Medscape’s Coronavirus Resource Center.

As the country rejects masks, physical distance, and other Covid-19 prevention strategies, elected officials and health departments are backing antiviral pills. However, the federal government does not say how many people received life-saving drugs or whether they were distributed fairly.

Pflovid tablets, in combination with Merck’s molnupiraviri, are intended to prevent morbidity or mortality in patients with mild or moderate Kovid. Every day, more than 300 Americans die from coccidiosis.

The number of national benefits that the Biden administration regularly shares is not the only information needed by local health workers to ensure that their residents have access to treatment. Recent federal changes that have allowed large pharmacy chains such as CVS and Walgreens to effectively manage their deliveries have had unintended consequences: Many public health workers are now unable to see how many doses have been sent or used to their communities. And they can’t say that the most vulnerable residents are filling recipes just like their rich neighbors.

KHN has repeatedly asked health and public service providers to share covid-therapeutic information and explain how to calculate its use, but they have not shared the total number of people who have taken Paxlovid.

So far, the most detailed calculations came from the manufacturers themselves. Pfizer CEO Albert Burla said 79,000 people recently received Paxlovid in the week it ended on April 22, up from 8,000 a week two months ago.

Unlike Covid vaccinations or cases, HHS does not monitor the race, ethnicity, age or place of residence of the people being treated. Vaccination numbers, initially announced by several states, allowed KHN to reveal racial differences a few weeks later. Federal data show that black, Native American, and Hispanic Americans died more than non-Hispanic white Americans.

The Los Angeles County Department of Public Health has worked to provide access to treatment for its 10 million residents, especially the most vulnerable. When the supply of Paxlovid was limited in the winter, local officials checked that the pharmacies of the severely affected communities were well covered, Dr. said. Seira Kurian, the department’s regional health officer. In April, the county launched its own telemedicine service to assess residents for free treatment, a model that eliminates many barriers to access to uninsured, rural or disabled patients in clinics located in commercial pharmacies.

But without federal data, they don’t know how many counties have taken the pill.

Real-time filling data shows that neighbors are filling out prescriptions as expected, or that they need to target public health workers for an educational campaign. Unavailable to federal systems, Los Angeles County, which serves more residents than the 40 state health departments, must use limited state inventory data published by HHS.

This data set contains only a fraction of the information and in some cases displays monthly data. Because it includes certain types of providers, such as nursing homes and Veterans Health Administration facilities, county officials cannot say whether patients there have taken the pills.

Due to the scarcity of data, Curian’s team conducted a survey and asked providers to provide the postcodes of patients receiving covid therapy. With the help of surveys, it is easy to determine which pharmacies and clinics need the most.

But not everyone will finish it, “he said.” In general, we still have to make predictions. “

In Atlanta, Good Samaritan Health Center staff use detailed information to refer low-income patients to Paxlovid pharmacies. Breanna Latrop, the center’s chief operating officer, said the drug would not be available immediately when the first omicron appeared, but the next would be a “new frontier”.

Ideally, he says, his staff will be able to see “everything you need to know in one place,” including which pharmacies have the pills, when they are open, and whether they offer home delivery. Student volunteers set up a similar database to test the center before the pandemic.

Paxlovid and molnupiravir were available in the United States in late December. They quickly became the treatment of choice for hospitalized patients, replacing almost all monoclonal antibody infusions that were ineffective against current covid strains.

Although the government did not use Paxlovid based on race or ethnicity, researchers found the same trend for first-generation infusions.

Now Feihan, co-author of a study funded by the CDC and a clinical researcher at Ochsner Health in Louisiana, found that black and Hispanic patients with Covid were less likely to receive primary outpatient treatment than white and non-Hispanic patients. Other researchers have found that language barriers, lack of transportation, and lack of treatment have all contributed to inequality. Feihan’s study, using data from 41 medical systems, found no significant differences for hospitalized patients who did not have to seek medication on their own.

According to Latrope, patients at Good Samaria Health Center in Atlanta are unaware that they can be quickly examined and treated. Some feel that they do not meet the requirements or that they cannot afford it. Others wonder if the pills work or are safe. “There are a lot of questions in people’s minds,” Latrop said, “about how it will benefit them.”

When Dr. “Our first priority was transparency and information sharing,” said Jeffrey Klausner, a deputy public health officer in San Francisco. “It’s important to build trust and work with the community.” Now a professor at the University of Southern California, he has to share the information available to federal and state officials, as well as gather detailed information about the patients being treated – race, ethnicity, age, severity – so they can fix all the injustices.

Public health officials and researchers who spoke to KHN said HHS staff may not think the data is accurate or that there are not enough staff to analyze it. Head of HHS Therapeutic Distribution Effort, Dr. Derek Eisnor made the suggestion during a meeting with state and local health officials on April 27. One local official asked the federal agency to share local numbers to intensify outreach to less-used communities. Eisnor did not ask HHS providers to say how much they used, so the report responded that it was “at best average” and added that he did not think it was his agency’s role to share this information.

Eisnor also said that state health departments should now be able to see local orders and use of pharmacies such as CVS, and he hopes the agency will soon release weekly national data online. However, counties that have failed to access federal systems, such as Los Angeles, still do not have access to the information they need to focus on information access efforts or to identify emerging disparities.

Spokesman Tim Granholm said HHS was looking for ways to share additional information with the public.

HHS weekly officials shared news about distribution plans, and recordings of meetings answering questions from public health workers, pharmacists and clinicians were posted online until March. The HHS media office has repeatedly denied access to KHN, saying “records are not open to the public.” According to Grenholm, HHS would like to encourage open communication during meetings. He did not say which legal authority would allow the agency to ban public meetings in the media. KHN obtained the public records through a Freedom of Information Act.

A senior White House official said Biden’s administration was trying to gather accurate data on how many people received Paxlovid and other treatment, but he did not say how many had made progress. Its main purpose, the official said, is to make sure that the public is aware of the availability of treatment and that doctors and other providers understand which patients are suitable for them.

We still need to know where the pills are going, Fehan said. “We need this information as soon as possible.”

Until then, Los Angeles County’s Kurian and his peers will continue to make “predictions” where residents need more help. “If someone can give us a report that has that information,” he said, “it will definitely make things easier.”


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