Which Pharmacy Is Open Right Now – GREENBELT, Md. – Last month, the owner of a small pharmacy here collected up to twenty-two courses of Pfizer’s new drug to treat Covid-19, which he wants to quickly distribute to his high-risk customers. many test positive for the virus.
More than a month later, Demmy’s Pharmacy distributed antiviral pills to just seven people. The rest of the animals are in well-packed rows on the shelves here in downtown Washington, D.C., and the owner, Adeolu Odewale, is struggling to figure out how to deliver the drug, Paxlovid, to other people because cases have increased more than 80 percent in Maryland. in recent days.
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“I never thought I’d be sitting on so many of them,” he said of the bills he has. “One just needs to know how to get it.”
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The national release of the drug, which was cleared by the Food and Drug Administration for emergency use in December, has proved more difficult and less effective than expected, leaving hundreds of thousands of studies not used as a case of Omicron BA.2 subvariant spike. The first type of treatment approved for Covid-12 patients and older with severe disease has not been available to many Americans for months as the practice escalates.
But with so much medicine, pharmacists, health experts and government health officials say, encouraging the right people to take it and making it easy to access can help impact of another wave of Covid.
State health officials say many Americans who would be good candidates for Paxlovid don’t seek it because they don’t know they’re eligible for it and are reluctant to take the drug. new or confused by some providers’ interpretation of the guidelines. for participation is less than others.
The national rollout of Paxlovid, the anti-Covid-19 pill, is more complicated and less effective than expected. Credit… Shuran Huang for The New York Times
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Because medication must be prescribed by a doctor, nurse or physician’s assistant, people must navigate the byzantine health care system to find medication, then find a prescription, all within days of five after developing symptoms. The medicine, which is prescribed as three pills to be taken twice a day for five days, is designed to start early in the course of the disease.
A new initiative by President Biden’s administration announced earlier this year, called “testing to medicine,” would allow people to visit hundreds of clinics. qualified, community health centers and long-term care facilities across the country to be tested. coronavirus and if so, take Paxlovid instead. But almost two months later, there is little time available, and there is no immediate access to treatment beyond what they already have in place, experts say. .
More than 630,000 courses of the drug – about a third of the supplies distributed so far – are now available, and the federal government sends 175,000 courses to the states every week, according to to government information. Its use has accelerated in recent weeks, agency officials said. Vice President Kamala Harris began a course of Paxlovid on Tuesday after testing positive for the virus, her press secretary said in a tweet, although it is not yet clear if she will make it. risk risk. But information about who received the drug — including nursing home residents, who may be among those most likely to benefit — remains scarce.
On Tuesday, the White House announced new measures to help lower the bills to eligible Americans, show how expensive they are and push doctors to stop thinking that treatment is too cheap.
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“The word on the street is that these things are not readily available, and you have to limit them to the highest-risk patients,” said Dr. Ashish K. Jha, the White House’s Covid-19 response coordinator, in a statement. in a statement on Sunday. “Too many doctors still hold that view.”
The officials also said that the drug administration will allow to start ordering the drug from the federal government, and will aim in the coming weeks to double the number of drugs it supplies. in the Covid-19 antiviral to 40,000.
There are more than 2,000 treatment trial locations, nearly half of which are CVS MinuteClinics with in-home nurses and aides who can prescribe the drug. Most locations include Walgreens, Kroger and other chain pharmacies, as well as state-funded health facilities.
According to public health experts and patients who have tried to navigate the program, it is still difficult to find a place and it takes a long time to get there. Much of rural America does not have easy access to the project.
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As a medical professional, Dr. Odewale does not have the authority to prescribe medicine, but he can conduct tests and vaccines for Covid-19. Credit… Shuran Huang for The New York Times
“It’s a good idea, it’s a barrier,” said Dr. Walid Gelad, an expert in pharmaceutical safety and drug safety at the University of Pittsburgh.
One of those obstacles, he said, is different interpretations of the admissions guidelines. Some health departments and doctors still adhere to the CDC’s definition of people at high risk of serious illness or death from Covid, which is not people 65 and older and those with chronic diseases, but people who are at higher risk based on “where they live or work, or because they don’t have access to health care.”
“In other cases, they’re saying, ‘Because of the shortage, we’re limiting it to high-risk patients,'” said Dr. Gelad, who recommends screening guidelines for medical professionals in Los Angeles County. .
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Dania Palanker, a research assistant professor at Georgetown University’s Center for Health Insurance Reform, recently tried to accelerate the test-for-treatment system by using the Biden administration’s new champion for Covid resources. -19. he calls it the “maze” of finding an appointment on the CVS website. He said he worries that those most in need of medication are those who fall through the cracks in the American health care system.
“You still have to have access to health insurance or be able to pay for the test up front,” he said.
Allowing pharmacists to prescribe Paxlovid, as some have been approved in Canada, will make it easier for those who need the drug, health experts say. Credit… Shuran Huang for The New York Times
Giving pharmacists the right to prescribe would help people get treatment faster, health experts say. But regulators at the F.D.A. and other federal health officials believe there is reason for pharmacists not to approve the drug Paxlovid, even though some Canadian pharmacists can. Treatment may involve some medications and a lower dose may be prescribed for people with kidney disease, which is measured by a blood test.
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Medical professionals say they are well trained and comfortable in performing such tests. Michael Ganio, executive director of pharmaceutical operations and quality at the American Society of Health-System Pharmacists, said that pharmacists could give Paxlovid to patients more quickly if they could prescribe “and don’t call the doctor’s office and wait for the call, hopefully. It will happen within five days.”
Noting that the MinuteClinics are in wealthy areas, he said of the treatment trial program, “In terms of expanding access, it did not do what it could, especially in the impossible place.”
Paxlovid use has exploded in recent weeks in Vermont as cases have increased there, a trend that can be attributed to growing awareness of the drug, said Dr. Mark Levin, the state health officer. But he said Vermont, which has high rates of patients with health insurance and primary care providers, would not benefit as much from a system like test-to-treat as others.
“Trial-to-treat is really good for places where you have a really hard time connecting people to health care,” said Dr. Levine said. “Many of these areas don’t have enough capacity in their primary care systems or they don’t have a fully insured population.”
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Although Paxlovid is free, patients without insurance and people with high deductible plans who seek a prescription from a medical clinic or urgent care center may be charged for consultation fees.
Amanda Fuller Moore, a pharmacist at the North Carolina Department of Health and Human Services, said uninsured people in her state are most concerned about the costs they face when looking for a test or prescription,” especially in an environment where it’s hard to know what that cost is.
New York City officials began a program over the winter that eased some of the burden by delivering bills directly to homes for free, a move praised by White House officials. .
But some Americans are still stuck without easy access to a health care provider, making it harder for rural states to provide good treatment. George Gerhardt, a health official in North Dakota, said the state is keeping stockpiles of medicine in case of an outbreak or shortage. The government does not
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