COVID therapies become more available at testing sites

​COLUMBUS, Ohio — A growing number of COVID-19 testing sites are offering oral therapy pills to eligible patients who test positive, but some sites said the lack of interest in the drug left them disappointed.

What do you want to know

  • COVID-19 oral antiviral treatments are available at testing sites
  • A new database shows locations participating in the program
  • Providers report low patient interest in life-saving drugs

Locations participating in the federal government’s “Test to Treat” program include pharmacy clinics, health centers and long-term care facilities. The Department of Health and Human Services launched a database on March 30 to help Americans locate therapeutics, and it includes more than 2,000 locations that participate in Test to Treat.

The sites offer Pfizer’s Paxlovid, the preferred oral antiviral treatment, and the drug Molnupiravir from Merck and Ridgeback, both of which have been shown to reduce the risk of serious illness and death.

At a health center in Lima, Ohio, Health Partners of Western Ohio’s Quick Care, most eligible patients do not want oral pills, said clinical director Dr. Warren Morris.

“We really thought there would be a lot more interest,” he said. “Most refuse medication when offered, and honestly, I don’t know why.”

Morris said they were seeing similar hesitancy to what they had seen in patients eligible for monoclonal antibodies, which were the primary outpatient treatments early in the pandemic. “No amount of explanation will change their minds,” he said.

Despite the lack of interest so far, Morris said Health Partners is proud to offer free COVID-19 testing and treatment, as one of the few places in Ohio to participate in the federal program. which is not a pharmacy chain. Most participating sites are CVS, Walgreens, and Kroger sites with clinics staffed by a nurse practitioner or physician assistant.

“The drugs seem to be very, very well tolerated from what we can tell, and they’re reasonably effective,” he said.

The drugs are approved for high-risk COVID-19 outpatients — people 65 and older and people with certain health conditions — and they must be taken within five days of the onset of symptoms. The diets involve taking a few pills a day for five days.

Beyond the Test to Treat program, there are many other providers that dispense prescriptions for antiviral pills, but most places either don’t have onsite testing or don’t have an onsite prescriber, who could be a doctor, an advanced practice registered nurse or medical assistant. Eligible patients who test positive are encouraged to speak to a healthcare professional about the drug.

Health associations have argued over how the drug should be prescribed to positive patients. The American Medical Association spoke out against the current protocols last month.

“Establishing pharmacy clinics as a one-stop shop for COVID-19 testing and treatment is extremely risky. Pharmacy clinics usually treat simple illnesses such as strep throat. Yet COVID-19 is a complex disease and there are many issues to consider when prescribing antiviral drugs for COVID-19,” the association said in a statement.

The American Pharmacists Association argued in a statement that the current plan is too narrow and argued for pharmacists to prescribe the drug.

Pharmacist Denise Conway, who owns two independent pharmacies in Ohio, said the program could have a significant benefit in the event of another COVID-19 surge. One of its locations, Conway Pharmacy in Danville, Ohio, is participating in Test to Treat, but no eligible patient has tested positive since receiving their supply of Paxlovid a few weeks ago.

“There hasn’t really been a need yet,” she said. “We’re sort of in a lull from any positive COVID tests.”

The pharmacy is next to a federally licensed health center, and Conway said they are working together so a patient can get a prescription from a provider at the health center if they test positive for the pharmacy. The pharmacy would then issue the prescription.

Conway Pharmacy is also working on a partnership with a telemedicine provider to add another option for patients to get prescriptions on the spot.

Conway said the pharmacy would receive modest payments from insurance companies for dispensing the pills and the federal government would pay for the drugs. She said it takes 30 to 45 minutes of a pharmacist’s time to go through the check-up process for oral antiviral pills, as they have to perform a thorough review due to possible drug interactions.

“Pharmacies are lucky to get $15, and so to be quite honest, that’s the disheartening part, and that’s why some pharmacies say, ‘No, I don’t,'” said she declared. “It’s a ton, a ton of time to spend on one prescription and making sure everything is correct.”

Conway said she wants her pharmacy to participate because she sees it as a unique opportunity to expand access in a rural area, and she fears we haven’t seen the latest surge of COVID-19 yet.