If only COVID-19 pills were advertised as enthusiastically as Easter candy.
With 1,400 Americans hospitalized with the disease every day, the main goal of President Biden’s ‘test to treat’ initiative is to provide antiviral pills quickly and on the spot to at-risk patients – right after they’ve been tested. positive for the virus. Even with low case numbers and assuaged anxieties, the program is seen as an essential tool in the country’s strategy to live with the virus – especially with the East Coast facing a new surge.
But at participating CVS pharmacies in the Bay Area, there is no signage to promote the program. To find their in-store MinuteClinics — which offer everything from earwax removal to TB testing, not to mention life-saving treatments — a visitor has to browse through rows of holiday baskets, marshmallow pink peeps and Cadbury Creme Eggs.
Independent pharmacies, which represent one-third of all retail pharmacies in the United States, are not included in the “test to treat” program. This makes it even harder for people in rural and underserved communities to access it, said Kurt Proctor of the National Community Pharmacists Association.
The program is not advertised on television, on the Internet or in newspapers. Although the locations are available on a recently revamped federal website, you should know how to look.
And because COVID antivirals haven’t yet received full FDA approval, they can’t get the glossy ads available for Lipitor, Viagra, or other blockbuster drugs.
Meanwhile, public demand for the drugs has been weaker than expected, even as the virus spreads, particularly in New York and Washington, D.C.
“Where is the national campaign to educate the public on what people should do?” asked Saad B. Omer, director of the Yale Institute for Global Health.
“We need to move forward,” he said, because “success of the test-to-treat strategy depends on prompt action by the public.”
The FDA has cleared two antiviral pills for the treatment of COVID-19: Pfizer’s Paxlovid and Merck’s molnupiravir, which carries the brand name Lagevrio. Paxlovid reduces the risk of hospitalization and death from COVID by 88%. Lagevrio reduces the risk by 30%.
By removing the need for a visit to the doctor, the “test to treat” approach was meant to facilitate access to prompt treatment.
But of the tens of thousands of retail pharmacies nationwide, the program is only offered at 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 usually greeted by a computer kiosk, not a person. There is no mention of the program or the medications. Same-day appointments may not be available, leading to infectious people leaving empty-handed.
CVS had no comment on the low profile of its screen.
“I haven’t seen a big rollout here in pharmacies with health clinics,” said Charles White, professor of pharmacy practice at the University of Connecticut School of Pharmacy. “It exists as a service, but not one that is specifically presented 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 doctor, these community pharmacists are not allowed to give the pill without a doctor’s prescription.
“There is 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 barred (community) pharmacists from being able to administer the life-saving antiviral drugs that represent the ‘treatment’ part of the program.”
According to Proctor, “‘test-to-treat’ options are not available to everyone everywhere, by far…The scope of assigned products is very limited.”
Fourteen independent pharmaceutical 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 hurdle: Only people at high risk for severe COVID are eligible. This is because supplies were initially very limited. They are now increasing.
Meanwhile, not enough doctors are prescribing the drugs.
Recent market research shows that only 17% of people who visit a health care provider with COVID were prescribed an oral antiviral, according to Dr. Jerome Adams, former US surgeon general under President Trump.
“Availability and perceived cost remain barriers to treatment,” he tweeted. “Clearly we need to do more than test, in order to treat adequately.”
As a result, demand in pharmacies has been lukewarm. Most Bay Area counties — such as Contra Costa, San Francisco, San Mateo and Santa Cruz — say they didn’t need their full allocation.
“We’ve seen retail pharmacies denied allowances because they were already overstocked,” said Brittany Goldman of Contra Costa Health Services, which launched an awareness campaign. In these cases, the county redirected the drug to other retail sites.
To find a test-to-treat location near you, go to: https://covid-19-test-to-treat-locator-dhhs.hub.arcgis.com/
Here is a list of Bay Area locations:
- Valley Health Center Lenzen, San Jose, CA 95126
- CVS Store, 2514 Berryessa Road, San Jose, CA 95132
- CVS Store, 1720 S Bascom Ave., Campbell, CA 95008
- CVS Store, 2700 Homestead Road, Santa Clara, CA 95051
- CVS Store, 45 N Milpitas Blvd., Milpitas, CA 95035
- CVS Store, 470 Blossom Hill Road, San Jose, CA 95123
- CVS Store, 576 E El Camino Real, Sunnyvale, CA 94087
- CVS Store, 10455 S De Anza Blvd., Cupertino, CA 95014
- CVS Store, 2630 W El Camino Real, Mountain View, CA 94040
- CVS Store, 16995 Walnut Grove Dr., Morgan Hill, CA 95037
- CVS Store, 987 E Hillsdale Blvd., Foster City, CA 94404
- CVS Store, 45 N Milpitas Blvd., Milpitas, CA 95035
- CVS Store, 1871 El Camino Real, Burlingame, CA 94010
- CVS Store, 10 Bayhill Shopping Center, San Bruno, CA 94066
- La Clinica De La Raza, 3451 E 12th St., Oakland, CA 94601
- Oakland Primary Care Children’s Hospital, 747 52nd St., Oakland, CA 94609
- CVS Store, 1451 Shattuck Ave., Berkeley, CA 94709
- CVS Store, 1123 S California Blvd., Walnut Creek, CA 94596
- CVS Store, 738 Bancroft Road, Walnut Creek, CA 94598
- CVS Store, 2455 San Ramon Valley Blvd., San Ramon, CA 94583
- CVS Store, 3999 Santa Rita Road, Pleasanton, CA 94588