New Haven, CT—While the distribution of oral COVID-19 therapies in the U.S. is generally going well, some gaps are concerning, according to a new study.

More than 90% of the U.S. population lives within 15 minutes of locations dispensing the products, according to an article in Journal of the American Medical Association Network Open, which added that “the national distribution of nirmatrelvir-ritonavir has been successful.”

On the other hand, authors from the Yale School of Medicine and colleagues reported that more than 6 million people in the U.S. live more than 30 minutes and 1.7 million live more than 45 minutes from the nearest dose of Paxlovid and other treatments.

“This number has not decreased much since May 2022 despite a substantial increase in dispensing locations,” they wrote, calling for further studies that are needed to evaluate these access disparities.

One of the limitations of the study is that access could be overestimated because “individual pharmacies may not always have sufficient doses on hand.”

The issue of pharmacies and Paxlovid distribution has been fraught. In mid-November, CVS Pharmacy announced that pharmacists at more than 9,000 of its locations would be able to clinically assess COVID-19-positive patients and, if eligible, prescribe Paxlovid, an oral antiviral treatment.

The FDA authorized pharmacists to provide Paxlovid in July, but it took 5 months before the first major drugstore chain announced that it actually was providing the service nationwide.

Pharmacy prescribing of Paxlovid was not widely implemented because of an unclear reimbursement structure for pharmacists to prescribe, something pharmacy associations have been working assiduously to resolve.

“Policymakers and healthcare systems need to continue to prioritize high-density areas when distributing antiviral supplies, and alternative arrangements should be made for those living in areas without ready access,” according to the authors of the recent access study. “Strategies may include offering delivery services, including mail, or establishing alternative local access points to ensure oral therapeutics are available to all who may need them.

The researchers used the Department of Health and Human Services COVID-19 Public Therapeutic Locator data set to identify all active locations at eight time points in 2022 (January 14, February 16, March 16, April 16, May 16, June 15, July 16, and August 16). The data were limited to facilities with oral outpatient therapies, nirmatrelvir-ritonavir, renally dosed nirmatrelvir-ritonavir, and molnupiravir.

The results indicated that the number of U.S. locations dispensing oral COVID-19 therapies increased from 5,476 in January 2022 to 95,797 by August 16, 2022. The study added that only 0.3% of the population lived more than 60 minutes away from the nearest dispenser, with that most likely to occur in South Dakota, North Dakota, Montana, Texas, and Nevada.

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