Despite Its Potential to Save Lives, Why Isn’t This COVID Drug More Widely Used? Here’s What You Need to Know

Covid 19 Antivirus Vaccine

As COVID-19 cases experience an uptick, the antiviral medication Paxlovid has been slow to gain widespread adoption among patients and physicians, despite its proven efficacy in reducing hospitalizations and deaths. A recent National Institutes of Health study, encompassing around 1 million individuals, revealed that only 15% of those at risk for severe disease opted for a five-day course of the prescription drug. Notably, Paxlovid demonstrated a 73% reduction in the risk of death and a 26% decrease in hospitalizations among those who took it, emphasizing its effectiveness for individuals susceptible to severe complications.

Despite the surge in COVID-19-related deaths, hospitalizations, and emergency room visits during the last week of December, the Centers for Disease Control and Prevention reported that these numbers remain below previous peaks. However, the slow adoption of Paxlovid by doctors can be attributed, in part, to concerns about potential interactions with other medications, even though patients can temporarily pause their other drugs for a few days.

One significant factor contributing to the underutilization of Paxlovid is the hesitancy among individuals who could potentially ward off a severe case of COVID-19. This reluctance may stem from concerns about minor side effects or affordability issues. Consequently, despite strong advocacy efforts by the Biden administration and public health officials, only a fraction of eligible individuals are currently receiving the medication.

Paxlovid, manufactured by Pfizer, is classified as an antiviral designed to inhibit the replication of the virus within the body. Comprising two drugs, ritonavir and nirmatrelvir, Paxlovid has demonstrated effectiveness in limiting the progression of the SARS-CoV-2 virus. Nirmatrelvir, an oval, pink pill, serves as a protease inhibitor, akin to drugs that transformed HIV into a manageable condition. Ritonavir, a white or off-white pill, enhances the activity of nirmatrelvir.

The typical duration for Paxlovid treatment involves a five-day course, with patients taking three pills twice a day. Most individuals report feeling better by the second or third day on the medication, highlighting its relatively swift impact on symptoms.

To obtain a Paxlovid prescription, individuals must consult with licensed healthcare professionals, including physicians, pharmacists, advanced practice registered nurses, and physician assistants. The medication is dispensed at pharmacies, and testing locations for those without health insurance can be found on the government’s official website. Quick testing after the onset of symptoms is crucial, as Paxlovid must be administered within five days to be effective.

Eligibility for Paxlovid extends to anyone aged 12 and older exhibiting symptoms and at high risk for severe disease. Given that common conditions, such as obesity, elevate the risk for severe disease, and individuals over 50 are eligible regardless of health status, a substantial portion of the adult population qualifies for the medication.

While the federal government initially provided millions of doses for free, Pfizer now distributes Paxlovid. The drug is priced at $1,390 per five-day course, with private insurance covering part of the charges. Medicare and Medicaid beneficiaries receive the drug for free until the end of the year, and those without health insurance can access Paxlovid without charges through 2028, as per an agreement with the Biden administration.

Despite the tolerable side effect profile, characterized primarily by a metallic taste in the mouth during the treatment period, some individuals may experience a phenomenon known as “rebound” – testing positive for COVID-19 or the recurrence of symptoms after recovery. However, research remains inconclusive on the prevalence of this phenomenon.

The sluggish pace of Paxlovid prescriptions aligns with patterns observed in the prescribing of other antiviral medications, such as Tamiflu for flu treatment, which are often underutilized. Concerns about potential drug interactions, particularly among urgent care doctors unfamiliar with a patient’s medical history, contribute to the slow adoption of Paxlovid.

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, deems this hesitancy a missed opportunity to prevent unnecessary hospitalizations and deaths, emphasizing Paxlovid’s role in preventing severe outcomes rather than expediting recovery.

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