How will Biden’s ‘Test to Treat’ initiative work for COVID-19?
How will Biden’s ‘Test to Treat’ initiative work for COVID-19?

How will Biden’s ‘Test to Treat’ initiative work for COVID-19?

Key takeaways

  • People with a variety of health conditions can reduce their chance of severe COVID-19 by getting early treatment with a COVID medication.
  • Test to Treat, an initiative just announced by the White House, will allow for faster administration of COVID-19 antiviral pills.
  • Those who are eligible will be able to take a test at a pharmacy and receive medication immediately if they test positive.
  • COVID-19 antiviral drugs are currently only approved for people with confirmed mild to moderate COVID-19 who are at high risk of developing a serious case.

President Biden announced a new one COVID-19 Strategy Plan in his State of the Union speech on March 1, including a “Test to Treat” initiative. As part of this initiative, people will be able to be tested for COVID-19 at a pharmacy and receive free on-site antiviral pills if they are positive.

Although cases are falling in the United States, easier access to COVID-19 drugs is crucial. Right now, getting treatment can be a lengthy process as it requires a positive test and a prescription. Both US-approved antiviral pills—Pfizers Paxlovid and Mercks molnupiravir-should be taken within five days of symptom onset.

In an email to reporters sent while President Biden was still holding his State of the Union address, a White House official shared details of the Test to Treat plan, explaining that the goal was “to minimize time between a positive test result and receipt of a test result. effective COVID-19 treatment, including antiviral pills and monoclonal antibodies. ”

In his speech, President Biden mentioned only Pfizer’s antiviral drug, Paxlovid. However, treatments approved by the Food and Drug Administration (FDA) to treat the currently circulating Omicron variant also include monoclonal antibodies, an antiviral pill from Merck and the drug remdesivir given as an infusion, according to treatment guidelines from NIAID.

According to the White House official, “under this program, people can be tested at local pharmacies and local health centers and receive antiviral pills right on the spot. The administration will launch these one-stop-shops this month, with hundreds of sites opening nationwide, including at pharmacy clinics in places like CVS, Walgreens and Kroger. ”

Who can take antiviral pills against COVID-19?

Paxlovid is available for people 12 years of age and older with confirmed mild to moderate COVID-19 who are at high risk of developing a severe case of the disease – meaning they may be hospitalized, in need of intensive care or die. Molnupiravir is approved for people 18 years of age and older with the same risk, but only when other FDA-authorized COVID-19 treatments are unavailable or inappropriate.

According to Center for Disease Control and Prevention (CDC), conditions and factors that may place someone at high risk for severe COVID include, but are not limited to:

  • Cancer
  • Chronic kidney disease
  • Chronic liver disease
  • Chronic lung disease
  • Cystic fibrosis
  • Dementia or other neurological conditions
  • Diabetes
  • downs Syndrome
  • Heart conditions
  • HIV
  • Immunocompromised state
  • Mental states
  • Obesity
  • Pregnancy
  • Sick cell disease
  • Smoking
  • Organ or blood stem cell transplant recipient
  • Battle
  • Substance Abuse Disorders
  • Tuberculosis

When does the Test to Treat program start?

Do not expect all pharmacies in corners to suddenly be a source of COVID treatment. At least so far, pharmacists can not prescribe COVID-19 treatments.

“I will refer you to each substance EUA (emergency use Authorization) fact sheet which lists the current prescribing authority… and currently does not include pharmacists, ”Matt Blanchette, head of retail communications for CVS Pharmacy, told Verywell via email. The fact sheets currently only allow physicians, nurses, and medical assistants to prescribe COVID-19 treatments.

Ilisa Bernstein, PharmD, JD, senior vice president of pharmacy practice and government affairs at the American Pharmacists Association, told Verywell that her organization is in discussions with the FDA to allow pharmacists to prescribe as well.

Roll-out details remain vague

The Department of Health and Human Services (HHS) did not return calls to Verywell about Test to Treat specifications on Wednesday, and the information is still meager even for professionals who will be involved.

“We will provide further details regarding rollout in our stores when it becomes available,” Walgreen spokeswoman Alexandra Brown told Verywell.

“We are still reviewing the new initiative and do not have many details on how the program will be structured,” Michael Ganio, PharmD, senior director of pharmacy and practice at the American Society of Health-System Pharmacists (ASHP), told Verywell.

Leana Wen, MD, an emergency physician and professor of health policy and management at George Washington University in Washington, DC, is concerned that Paxlovid, which is currently in short supply, will not be given sufficient priority under the new initiative for those most likely to need it. before that.

“Right now, there are such limited supplies of Paxlovid that these doses need to be reserved for those most likely to become seriously ill, such as the immunocompromised or the elderly and medically vulnerable,” Wen told Verywell. “In the future, oral antiviral drugs against coronavirus should be like Tamiflu for influenza – if people test positive, they should be able to immediately access an antiviral drug that dramatically reduces their risk of serious illness. It benefits the individual and also prevents stressful hospitals. . ”

The White House said Pfizer would deliver one million treatments in March and double that amount in April. How much is needed, of course, depends on whether there is a new increase or variant of COVID-19. And if there is, it remains to be seen whether Paxlovid will remain effective.

Prescriptions require review of the patient’s medical record

Getting and taking Paxlovid is not quite just as easily as President Biden made it work in his State of the Union speech.

The treatment consists of 40 pills over five days. Paxlovid interacts with a wide range of other drugs, including two statins for the treatment of high cholesterol and several epilepsy medications. It is not indicated for people with some serious health conditions, such as severe liver disease.

In some cases, patients may simply abstain from their other medicines while taking Paxlovid, Amesh Adalja, MD, a senior researcher at the Johns Hopkins Center for Health Security, told Verywell. But he said some drugs can not be paused and that others take a long time before the body is ready.

If Paxlovid is not an option for a patient, Merck’s antiviral pill, molnupiravir, is an alternative, but it’s just about 30% effective on reducing admissions, compared to Paxlovid’s 89%. Monoclonal antibody treatments are an option for most patients, but require an infusion at a treatment center.

Testing for treatment may be your fastest way to treatment

Once it’s up and running, the White House Test to Treat program may be the fastest way to treatment.

“I think the priority is to get the pills in hand as soon as possible,” Adalja said. “Even for those with primary providers, Test to Treat can be faster than theirs [own doctor] prescribing antiviral drugs. ”

No primary care physician and no Test to Treat clinic near you yet? Adalja recommends these options:

What this means for you

It may take time for the Test to Treat program to reach your area. If you have COVID-19 symptoms or test positive and have a primary care physician, contact immediately. If you do not have a personal physician and think you may have been positively exposed or tested, local acute care centers and local health clinics can help you access tests and – if you need it – care.

The information in this article is current from the date stated, which means that more recent information may be available as you read this. For the latest updates on COVID-19, visit our coronavirus news site.

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