How to find life-saving COVID-19 medication. Look past the Easter candy

If only COVID-19 pills were advertised as enthusiastically as Easter candy.

With 1,400 Americans hospitalized with the disease each day, the key goal of President Biden’s “test to treat” initiative is to get antiviral pills to at-risk patients fast and on the spot — right after they test positive for the virus. Even with case numbers low and anxieties easing, the program is considered a critical tool in the country’s strategy of living with the virus — especially with the East Coast facing a new surge.

But at CVS pharmacies participating in the Bay Area, there’s no signage to promote the program. To find their in-store MinuteClinics – which offer everything from ear wax removal to TB tests, yet fail to mention the life-saving treatments – a visitor must navigate past rows of holiday baskets, pink marshmallow Peeps and Cadbury Crème Eggs.

Independent pharmacies, which represent one-third of all retail pharmacies in the U.S., aren’t included in the “test to treat” program. So it’s even harder for people in rural and underserved communities to gain access, said Kurt Proctor of the National Community Pharmacists Association.

The program isn’t publicized on TV, the internet or in newspapers. While locations are available on a newly revamped federal website, you need to know to look.

And because the COVID antivirals haven’t yet received full FDA approval, they can’t get the glossy advertisements available to Lipitor, Viagra or other blockbuster drugs.

Meanwhile, public demand for the medications has been lower than expected, even as the virus spreads, especially in New York and Washington, D.C.

“Where’s the national campaign to educate the public about what people need to do?” asked Saad B. Omer, director of Yale’s Institute for Global Health.

“We need to get ahead of this,” he said, because the “success of test-to-treat strategy depends on public acting fast.”

The FDA has authorized two antiviral pills for treating COVID-19: Pfizer’s Paxlovid and Merck’s molnupiravir, which has a brand name of Lagevrio. Paxlovid reduces the risk of hospitalization and death from COVID by 88%. Lagevrio reduces risk by 30%.

By removing the need for a doctor’s visit, the “test to treat” approach was supposed to ease access to quick treatment.

But of the tens of thousands of retail pharmacies nationwide, the program is offered at only hundreds of select “big box” pharmacies including CVS in the Bay as well as Walgreens and RiteAid elsewhere. Visitors to these in-store clinics are typically greeted by a computer kiosk, not a person. There’s no mention of the program or medicines. Same-day appointments may not be available, leading infectious people to leave empty-handed.

CVS had no comment about its display’s low-profile.

“I have not seen a big rollout here in the pharmacies with health clinics,” said Charles White, professor of Pharmacy Practice at University of Connecticut’s School of Pharmacy. “It does exist as a service, but not one that is being specifically touted with signage.”

With over 85% of Americans living within five miles of a community pharmacy, pharmacists are often the closest health care provider. But without a special license or agreement with a physician, those community pharmacists aren’t empowered to give the pill without a physician’s prescription.

“There’s a problem with the plan,” said Danny Sanchez of EnlivenHealth, a Mountain View-based provider of medication management and software tools for pharmacies. “The FDA recently prohibited (community) pharmacists from being able to administer the life-saving antiviral medications that represent the ‘treat’ portion of the program.”

According to Proctor, “the ‘test to treat’ options are not available everywhere to everybody, by any stretch…The reach of the products being allocated are very limited.”

Fourteen independent pharmacy organizations recently sent a letter to the Biden administration to expand patient access to the “Test to Treat” initiative by removing barriers that prevent pharmacists from ordering oral antivirals.

There’s another obstacle: Only people at high risk of severe COVID are eligible. That’s because supplies were initially very limited. They are now increasing.

Meanwhile, not enough physicians are prescribing the drugs.

Recent market research shows only 17% of people who go to a health provider with COVID were prescribed an oral antiviral, according to Dr. Jerome Adams, former U.S. Surgeon General under President Trump.