If many doctors are unaware of these therapeutics or unsure how patients qualify for them, where’s the effective awareness and education campaign for health care providers?
In the United States, such doctor outreach is often, sadly, left to pharmaceutical companies, which spend tens of billions of dollars each year marketing their drugs to physicians. This has led to heavily promoted drugs getting prescribed even when cheaper, effective alternatives exist. However, Paxlovid received an emergency use authorization, which means that legally, Pfizer cannot directly market it yet, so physicians don’t get even this sort of outreach. This leaves individual doctors on their own for keeping up with new drugs and treatments, even in a pandemic and even when the drug is potentially lifesaving.
Plus, it’s not that easy to get a same-day appointment with one’s regular physician, even for those who have great insurance. This makes catching the early treatment window harder. In most places, emergency rooms are always open, but besides being overloaded and understaffed, they are the last places where infected people should congregate or where the elderly or high-risk should spend hours merely to get access to a crucial drug.
A similar situation is underway for Evusheld, a Covid drug approved in December for the millions of immunocompromised people, like transplant patients and those on medications that can suppress the immune system for conditions like rheumatoid arthritis. In trials, the drug reduced symptomatic infections by about 83 percent at six months. This drug provides them with extra protection for six months as a prophylactic. It’s been approved for months, and Biden also mentioned treatments for the immunocompromised in his State of the Union address. The federal government bought 1,700,000 doses, to be distributed free.
So I guess this is where I should say, “Stop me if you heard this before.”
In March, The New York Times reported that a whopping 80 percent of the doses were sitting unused as the Omicron wave washed over the country. A CNN investigation found desperate patients unable to find the drug, doctors unaware that it even exists and some pharmacies with hundreds of unused doses while others had none. Hospitals like the Mayo Clinic told CNN that they had only a few thousand boxes for the more than 10,000 patients who could benefit from it, while boxes were delivered to medical spas offering Botox or eyelash extensions (and sitting unused). The Detroit Free Press found supplies of Paxlovid and Evusheld unused because physicians weren’t prescribing them. A Kaiser Health News investigation found that government maps of supplies were missing many locations that had doses. This happened even as desperate patients waited for lotteries to allocate some to them. Social media is also replete with stories of despondent patients unable to locate doses or managing to do so after much effort and paying extra when they ended up out of their insurance networks. Meanwhile, at least one infusion center had so many unused doses that it ran out of refrigerator space and declined new shipments.
What makes this all more troubling is that conditions like diabetes and uncontrolled high blood pressure increase the dangers of Covid and the United States has had a worse record on such health indicators than many other wealthy nations.
Not having a regular relationship with a medical provider — too common in the United States — leaves these high-risk people open to confusion and misinformation, especially in the current political environment. People without insurance lagged in being vaccinated at all and will face more obstacles in getting antivirals.