The COVID States Project #90: Utilization rates of antivirals for COVID-19

Antiviral therapies, specifically Paxlovid1 and Molnupiravir2, are highly effective in reducing the risk of hospitalization or death from COVID-19. Clinical trials found that Paxlovid could reduce the risk of death by as much as 89%.3 In light of the massive number of COVID-19 deaths - 400,000 deaths last year, which places it third among leading causes of death in the US, after heart disease and cancer - this suggests the potential benefit of these interventions could be profound.4While Paxlovid has been available since December 22, 2021,5 there have been challenges in its clinical application. In order to be effective, it needs to be used within 5 days of symptoms occurring, i.e., before it is clear how serious the course of illness will be. During this critical time window, patients must confirm infection, obtain a prescription from their doctor and locate a pharmacy that has the antiviral in stock. The FDA declared on May 4th, 2022, that "Paxlovid is now widely available at community pharmacies."6Despite policy efforts to make them widely prescribed, such as COVID-19 Public Therapeutic Locator website,7 the public's awareness and access to antivirals has been spotty. News reports have emphasized the “Paxlovid rebound” (a return of a positive test after taking Paxlovid), rather than the high efficacy of the antiviral at preventing death. Uneven distribution8 and unclear guidance from the federal government have resulted in shortages and confusion at the state and local levels among eligible patients and their healthcare providers.9