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January 21, 2022

Why was it so hard for this woman to access Covid-19 antivirals?

Daily Briefing

    As demand for Covid-19 antiviral treatments surges, limited supply has made them hard to find—a challenge that led one woman on a "seven-hour odyssey" to get antiviral pills for her mother.

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    Supply issues

    According to STAT News, more than 60% of American adults are estimated to have at least one chronic condition that places them in the high-risk category for severe Covid-19. Unfortunately, the increasing demand for Covid-19 antiviral treatments that these populations may benefit from—such as Pfizer's antiviral pill, Paxlovid—far surpasses the drug's supply. 

    On Jan. 7, there were 33,000 new cases of Covid-19 diagnosed in Pennsylvania—by far the highest number since the pandemic began. However, Pennsylvania received just 2,080 total treatment courses of Paxlovid in its initial allocation from the federal government.

    Similarly, during the first week of Paxlovid's distribution, Michigan only received 1,600 courses of the drug, and Wyoming was sent just enough for 100 people.

    Although additional shipments are expected to increase some time in the next month, nationwide shortages are expected to persist until April.

    As a result, several states, including Arizona, Georgia, Pennsylvania, and Virginia, have been distributing Paxlovid to commercial retail pharmacies instead of hospitals, STAT News reports.

    Since Paxlovid is an at-home treatment, pharmacy-based distribution could make the drug easier to access for some patients, according to STAT News. However, pharmacies cannot easily verify patient eligibility or determine which patients are at highest risk for severe Covid-19—which may hinder access for some high-risk patients who could benefit most from the treatment.

    A 'seven-hour odyssey' to find Covid-19 antivirals

    This scarcity was particularly challenging for Rebecca Robbins, a New York Times reporter who set out to find an antiviral treatment when her mother, Mary Ann Neilsen, tested positive for Covid-19.

    As a 73-year-old with several risk factors, including surviving breast cancer twice, Neilsen was eligible to receive several treatments, including monoclonal antibody infusions and antiviral pills—but Robbins knew these treatments would be hard to find.

    "Having spent the past year writing about Covid-19 vaccines and treatments for The New York Times, I knew a lot about the options available to people like my mother," Robbins wrote, "Yet I was about to go on a seven-hour odyssey that would show me there was a lot I didn't grasp."

    First, Robbins searched online to find lists of pharmacies that potentially had either GlaxoSmithKline's antibody infusion or Pfizer's Paxlovid pill in stock.

    Robbins checked a federal database, which reported only one listing within 25 miles of her mother. Then, she searched a separate federal database of pharmacy chains, hospital systems and other providers that placed orders for the treatments. She called several pharmacies before finding a Rite Aid store that had Paxlovid in stock.

    But Robbins' mom still needed a prescription—and when Neilsen called her doctor to try to get a prescription for Paxlovid, the receptionist told her they "don't do" prescriptions for the Glaxo or Pfizer treatments. And when Robbins tried to find a provider that would write her mother a prescription, many of them told her that they could only write Paxlovid prescriptions during an in-person appointment.

    Moreover, some facilities provided her with information that was incorrect. "One person told me that no monoclonal antibody treatments were available in California. Another insisted that Paxlovid was only for hospitalized patients," Robbins wrote.

    In the end, her mother got an unexpected call from a doctor with her primary care provider who phoned in the prescription after hearing about her symptoms.

    Ultimately, an Uber driver "came to the rescue," driving 60 miles to deliver the pills to Robbins' mother—who took the first dose within minutes of the delivery. "Taking meds & very thankful to have them," she texted in the family group chat.

    Although Robbins was able to find the treatment for her mother, she was discouraged by the search, saying, "the fact that the process was so hard for a journalist whose job it is to understand how Paxlovid gets delivered is not encouraging. I worry that many patients or their family would give up when told 'no' as many times as I was," Robbins wrote. (Robbins, New York Times, 1/19; Lynch/Hamilton, STAT News, 1/19)

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