US working to make Covid drugs more widely available as cases fall

President Joe Biden’s administration is striving to expand availability of the life-saving coronavirus antiviral treatment Paxlovid, and it is simultaneously seeking to reassure doctors that there is ample supply for people at high risk of severe illness or death from the virus.

The Food and Drug Administration first approved Paxlovid, produced by Pfizer, for emergency use in December. Supply of the regimen was initially very limited, but as Covid-19 cases across the country have fallen and manufacturing has increased, it is now far more abundant. The White House is now moving to raise awareness of the pill and its availability, as well as making it easier to access.

The White House said Tuesday it is increasingly reaching out to doctors and announced that the drug will now be shipped directly to pharmacies, in addition to existing distribution channels run by states. That is expected to increase the number of sites from 20,000 to more than 30,000 next week and eventually to 40,000 locations.

However, according to a senior Biden administration official speaking anonymously to Axios, many states are ordering just two-thirds of what is available to them and are using half their orders.

Providers are probably limiting access to the pill because “we’ve had the experience in this pandemic before of operating in a scarcity mindset,” another administration official said in a press conference.

Many states have opted for a lottery system to allocate Paxlovid and other Covid-19 drugs, often choosing to distribute the drugs to retail pharmacies instead of hospitals and clinics.

According to Dr Douglas White, a University of Pittsburgh critical care doctor who helped design Pennsylvania’s lottery system for Covid-19 drug allocation, the system ends up favoring people who are not only aware of the drugs but have access to doctors to prescribe it and the ability to locate pharmacies that have them in stock.

“The wealthy and well-connected will win the race,” White told the Los Angeles Times. It’s “the poster child for an unfair system.”

Despite the administration’s attempt to reassure providers that there are enough pills for patients, in an interview with NPR on Monday, the White House’s Covid-19 response coordinator, Dr Ashish Jha, said that there are only enough pills “for the short run.” As of Tuesday, the US had ordered enough supply of the pills for 20 million people, which is estimated to last for several more months.

“Right now, we’ve done a really good job of acquiring pills,” Jha said, adding that the Biden administration will need additional funding from Congress to acquire more pills. “We have to make sure that this is more than a short-term solution.”

Jha warned that the US will be running out of money for Paxlovid “reasonably soon,” and that “we actually aren’t even going to be able to pay our bills for what we’ve already entered into a contract with Pfizer for, so that’s going to be a problem.”

The Biden administration is expected to renew its request to Congress for $22bn in Covid-19 funding.

Paxlovid, when administered within five days of symptoms appearing, has been proven to bring about a 90% reduction in hospitalizations and deaths among patients most likely to get severe disease. About 350 Americans are now dying each day from Covid-19, down from more than 2,600 during the height of the Omicron wave earlier this year.

The FDA authorized Pfizer’s drug for emergency use in adults and children age 12 or older with a positive Covid-19 test and early symptoms who face the highest risk of severe outcomes. That includes older people and those with conditions like obesity and heart disease, though the drug is not recommended for patients with severe kidney or liver problems.

The administration is also working to expand the number of “test-to-treat” sites that provide a one-stop shop for those with Covid-19 to get tested for the virus, consult with a medical professional if they’re positive and fill a prescription for Paxlovid on site.

There are now 2,200 such locations nationwide, though the administration hopes more sites come online in the next several weeks with support from the Department of Health and Human Services, the Federal Emergency Management Agency and pharmacy companies.

The Associated Press contributed to this report.