Biden Administration to Expand COVID-19 Antiviral Access in Pharmacies

The White House on Tuesday announced plans to improve access to COVID-19 oral antiviral treatments, by nearly doubling the number of pharmacies that carry the drugs and encouraging providers to prescribe them.

During the Omicron surge, many COVID-positive patients struggled to get their hands on the life-saving antiviral drugs. Now, the White House said Pfizer’s Paxlovid and Merck’s Lagevrio are in “ample supply,” but the pills aren’t getting into the hands of those who need them.

Paxlovid can reduce the risk of hospitalization or death by almost 90% when taken within three to five days of symptom onset. It is authorized for people who are 12 years or older, 88 pounds or heavier, and are at high risk for developing severe COVID-19. COVID-positive individuals can pick up the pills at a pharmacy or clinic and take them at home—a simpler option than visiting a hospital for a monoclonal antibody infusion.

The White House said it will now allow pharmacies to order Paxlovid directly from the federal government at no cost. It will additionally expand its “test-to-treat” program, in which people can get tested for COVID-19 at participating pharmacies and receive antivirals on the spot if they’re positive. Many locations of major pharmacy chains—including CVS, Walgreens, and Walmart—are part of the program.

“It’s all about access right now,” Stephen Ferrara, DNP, FNP-BC, FAANP, FAAN, a director at the American Association of Nurse Practitioners and associate dean of clinical affairs at Columbia University School of Nursing, told Verywell. “It’s about patients having evidence-based information and being able to get to their practitioner when they need [treatment].”

Meanwhile, BA.2, a highly transmissible subvariant of Omicron, continues to drive new cases. The seven-day average of new COVID-19 cases was about 47,400 on Monday, up from nearly 37,300 the week prior. The true number of cases may be even higher, as many people are using at-home rapid tests and the results aren’t often reported to health agencies.

Antivirals will be key for tamping hospitalizations and deaths as cases rise, Ferrara said.

Streamlined Access to Antivirals

Without the “test-to-treat” program, patients with COVID-19 have five days to get a prescription for the antivirals after developing symptoms, and then they have to hunt down a pharmacy that has the drugs in stock. The White House is hoping the streamlined “test-to-treat” process can help more patients start treatment within the five-day window.

There are currently more than 2,200 test-to-treat sites. The White House said with the help of these sites, the use of antiviral drugs has more than doubled in the last few weeks.

In the beginning of the year, few pharmacies carried COVID-19 antivirals. Now, there are more than 640,000 courses of Paxlovid and more than 1.2 million courses of Lagevrio available across the United States.

“There is plenty of drug around—it is being underutilized,” Anthony Fauci, the White House chief medical adviser, told MSNBC. Part of the reason why, he said, is because health providers may not realize this is an available intervention.

The Biden administration said it would improve education for providers about when to prescribe the drugs, their possible side effects, and drug-to-drug interactions. Because these medications are fairly new, Ferrara said that providing regular updates on new research may encourage providers to prescribe them with more confidence.

“Education is key to the frontline providers,” Ferrara said. “You can never have enough resource information for clinicians.”

What to Do If You Test Positive for COVID-19

During the first Omicron surge, the drugs were so scarce that providers followed triaging guidelines to determine how to prioritize prescriptions for the most at-risk patients. To receive an antiviral prescription now, patients need only fit the clinical criteria.

“When Paxlovid first became available, the word on the street was these things are not widely available, you should restrict it to the highest risk patients,” Ashish Jha, the White House COVID Response Coordinator, said at a briefing Tuesday. “Anybody who is eligible, anybody who’s high risk, should be getting Paxlovid.”

A course of Paxlovid contains 30 pills to be taken over 5 days. The antivirals are free to anyone who needs them, regardless of insurance status. But to get a prescription, some people may need to pay an out-of-pocket fee for a visit with their provider. Jha said there are some community health clinics and pharmacies at which uninsured individuals can get a prescription at no cost.

If you test positive for COVID-19, Ferrara recommends reaching out to your health care team. They can help you assess your risk factors and answer questions about how the safety and effectiveness of the antivirals.

“As a clinician, my job is to not only diagnose and treat my patients, but it’s to educate them as well, about the risks and benefits of treatment,” Ferrara said. He said it’s key to get the message out to patients that there are safe and effective options to prevent severe disease.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.