Paxlovid, a Powerful Tool, Remains Out of Reach for Many
Tens of thousands of Americans are being hospitalized with COVID-19 every week, and thousands are losing their lives to the virus every month. Despite the availability of an effective antiviral treatment, Paxlovid, its potential to reduce severe outcomes is being underutilized. The high cost of the drug and doctors’ reluctance to prescribe it have resulted in limited access to this five-day treatment.
Experts regard Paxlovid as a valuable tool in preventing hospitalization and death from COVID-19. Dr. Amesh Adalja, a senior scholar at Johns Hopkins University, emphasized the preventable nature of many hospitalizations, stating, “When you read in your local newspaper that in this hospital, they’ve got this many COVID patients, most of those are preventable hospitalizations.” According to the Centers for Disease Control and Prevention, Paxlovid can reduce the risk of hospitalization in adults by 51% and is recommended for older individuals and adults with specific underlying conditions.
Accessibility Challenges
Initially authorized for emergency use in the U.S. in December 2021, Paxlovid was provided free of charge to those in need. However, after government funding ceased, Pfizer established a list price of $1,390 for the drug. While Paxlovid remains free for individuals on federal insurance programs like Medicaid and Medicare until the end of this year, uninsured individuals can also access it at no cost. However, many people need to navigate Pfizer’s patient assistance program to receive the necessary discounts. Additionally, a separate co-pay assistance program offers financial support to those with commercial insurance and high out-of-pocket costs.
Independent pharmacy owners have raised concerns about carrying Paxlovid due to low reimbursement rates from commercial insurers. Kurt Proctor, a senior vice president at the National Community Pharmacists Association, explained, “If you’re losing 5% on a $10 prescription, it’s very different than losing 5% on a $1,400 prescription product.” The high list price has also deterred some patients from pursuing the treatment.
Cautious Doctors and Potential Drug Interactions
Another obstacle to Paxlovid’s uptake is doctors’ hesitancy to prescribe the drug due to the extensive list of medications that should not be taken in conjunction with it. Many physicians may decide that the risk of potential drug interactions outweighs the benefits of prescribing Paxlovid. Dr. Sarah George, an infectious diseases professor at St. Louis University, acknowledged the inconvenience of checking for interactions, stating, “If people are on four or five different medications, it does tend to be a pain to double-check ‘is there an interaction here?'” This concern, even with possible workarounds, can dissuade doctors from prescribing the medication.
Study Highlights Missed Opportunities
A recent study conducted by Harvard researchers revealed that Paxlovid was disproportionately administered to Medicare patients with a lower risk of severe infection. The authors of the study estimated that if Paxlovid had been appropriately utilized, over 16,000 COVID-19 deaths could have been prevented. Dr. Michael Barnett, a Harvard health policy researcher involved in the study, emphasized the need for a change, stating, “There are very few medications and very few patients whose potential medication interaction with Paxlovid is so severe that they’re better off not taking Paxlovid.” He further emphasized that “very few of them are important enough that it’s a big risk to stop for a week.”
It is clear that the potential benefits of Paxlovid are not reaching those who need it the most. With proper utilization, this antiviral treatment could significantly reduce hospitalizations and deaths caused by COVID-19.
