While the United States is seeing a surge in COVID-19 cases once again, the use of the antiviral drug Paxlovid has not followed this trend. Despite being highly successful in preventing serious complications from COVID-19, the New York Times has reported that, according to a study conducted by the National Institute of Health (NIH), only 15 percent of those eligible for Paxlovid use the drug during the course of their illness. Eligible adults include those 65 years and older, and those with chronic conditions such as diabetes and asthma. The NIH study further concluded that if this number had increased from 15 to 50 percent during their research, 48,000 lives could have been saved. Researchers at the NIH determined that for high-risk patients who did take it, Paxlovid reduced the risk of mortality from COVID-19 by 73 percent.
Knowing Paxlovid’s remarkable effectiveness at saving lives from COVID-19, researchers are concerned that Americans are not utilizing this tool. Several explanations have been proposed as to why this could be. One explanation could be the drug’s infamous metallic aftertaste. It could also be related to the drug’s multiple interactions, as there are numerous common medications that can’t be taken at the same time as Paxlovid. Another explanation could be the fact that COVID-19 tends to get worse as it progresses; people initially do not feel that sick and think that they don’t need the drug. When they do start to experience more severe symptoms, it is too late to take Paxlovid, as the drug works by reducing viral growth in the initial stages of the disease. A recent study has found that Paxlovid is significantly more effective when taken on Day 1 of symptoms, as opposed to on even Day 2 or 3. Thus, it is imperative that those who could benefit from the drug start taking Paxlovid as soon as they experience symptoms.
The widespread discussion of “Paxlovid rebound” may also be to blame for its lack of use. This is the idea that while initially reducing COVID-19 symptoms, Paxlovid can lead to a resurgence of these symptoms (a “rebound”) later in the disease. However, the Center for Disease Control (CDC) has refuted this claim, finding that COVID rebound is not associated with Paxlovid use, and can occur even without taking the drug.
Cost is another significant, albeit recent, barrier to accessing Paxlovid. Until very recently, the United States government made the drug free for all who were eligible to take it. While it remains free for Medicaid and Medicare patients until the end of 2024, the government has now transferred Paxlovid’s distribution to Pfizer. The company is charging $1400 per 5 day course of the drug, and the amount that private insurance companies choose to cover may vary.
Finally, people may not be using Paxlovid because they simply don’t believe that they need it. A study from the City University of New York found that although 80% of those they surveyed were aware of Paxlovid’s availability, many survey respondents were not aware of their own risks for severe disease. For example, the study found that only one third of those over the age of 65 identified themselves as high risk for severe complications of COVID-19, despite the CDC guidelines saying that everyone over the age of 65 is considered high risk. Another study found that only one third of nursing home patients were taking the drug during their course of COVID-19, despite this being another extremely high risk group.
Additionally, it’s important to note that the use of Paxlovid is not consistent throughout the United States. There are significant geographic and socioeconomic differences in utilization of the drug. In the aforementioned NIH study, it was found that up to half of eligible patients were taking Paxlovid in the American Northwest and Northeast, as well as in the state of Utah. On the other hand, Paxlovid use was almost zero in areas of the Southeast and Midwest. Another study found that despite the overall rate of Paxlovid use being about 14%, Black patients took Paxlovid at a rate of 7%, and patients who were in the lowest income levels took it at a rate of about 11%.
To read the full article by Christina Jewett of the New York Times, click here.
For more on COVID-19, click here.