The rollout of the US government’s Covid-19 test-to-treat program is underway, with in-pharmacy clinics ordering shipments of Covid-19 antiviral medications and some locations expecting to offer the service within days.
“We’ve had more than 1,000 pharmacy-based clinic sites register today, so that even exceeded our expectations for Day One of this program,” Dr. Tom Inglesby, senior adviser to the White House’s Covid-19 Response Team, told CNN on Monday.
The Covid-19 antiviral pills Paxlovid and molnupiravir are already available for free in the United States, but quick access can be challenging for some people.
Last week, in its new National Covid-19 Preparedness Plan, the White House announced the test-to-treat initiative, in which people can visit “one-stop” sites that offer free Covid-19 testing and that prescribe free antiviral pills on the spot if they test positive.
“If you get Covid-19, the Pfizer pill reduces your chances of ending up in the hospital by 90%,” President Joe Biden said in his State of the Union address last week. “I’ve ordered more pills than anyone in the world has. Pfizer is working overtime to get us a million pills this month and more than double that next month.”
Here’s what you need to know about getting the Covid-19 medicines that you can take at home through the test-to-treat program.
When will test-to-treat services begin?
Although the ordering of Covid-19 antiviral medications is now underway, the orders have to be delivered to sites before they can be prescribed. Patients are expected to be able to receive Covid-19 antivirals through the test-to-treat program at some sites later this week.
The medicines haven’t been delivered to the sites yet, but “they’re going to be making their way there,” Inglesby told CNN on Monday.
“The ordering process has launched today in pharmacy-based clinics around the country,” he said, adding that as orders for the antiviral medications come in, shipments will be sorted out within a day or so.
Where can I get test-to-treat services?
The “one-stop” test-to-treat locations will be available at hundreds of sites nationwide, including pharmacies that have clinics, federally qualified health centers and long-term care facilities, according to the US Department of Health and Human Services.
Certain pharmacies across the United States – including CVS, Walgreens and Walmart – have confirmed to CNN that some of their locations are preparing to participate in the test-to-treat program, such as Minute Clinic locations in CVS pharmacies.
“We’ve begun ordering COVID-19 antiviral medications directly through the Federal Government as part of the Test to Treat program,” CVS spokesperson Matt Blanchette wrote in an email Tuesday. “We’ll begin offering end-to-end access to these therapies in our nearly 1,200 MinuteClinic medical clinics, located inside select CVS Pharmacy locations, when the allocation arrives, which is expected to start as early as this week.”
Walgreens pharmacies have administered more than 26 million Covid-19 tests during the pandemic and more recently began dispensing Covid-19 antiviral pills, spokesperson Karen May wrote in an email last week.
On Tuesday, May added, “Through the test to treat program, patients will be able to receive oral COVID-19 antivirals in select Walgreens stores where we have provider partners that are able to assess patients and prescribe these therapies later this week.”
How can people find test-to-treat sites?
HHS announced Tuesday that a federal test-to-treat website where people can find nearby locations participating in the program is “in development.”
The website is anticipated to launch in mid-March.
Who can receive test-to-treat services?
There are two antiviral pills authorized by the US Food and Drug Administration to treat Covid-19 at home: Pfizer’s Paxlovid for people 12 and older, and Merck’s molnupiravir for adults. Anyone in those age groups who tests positive for Covid-19 could be prescribed the medications to take at home.
The treatments work best when a person takes them within a few days of symptoms starting or testing positive – even if their symptoms are mild.
Only one positive Covid-19 test is needed for treatment, Inglesby said, and it does not have to be a PCR test: “Any positive test should be sufficient.”
Who will prescribe the treatments?
The FDA’s emergency use authorization for the medicines notes that physicians, advanced practice registered nurses and physician assistants who are licensed or authorized under state law to prescribe these types of drugs can do so.
Pharmacists themselves will not be able to prescribe the oral antiviral pills. Rather, the test-to-treat sites have health care providers available who can assess and discuss relevant treatment options and prescribe the drugs, according to HHS.
In a statement Friday, the American Medical Association noted concern about allowing pharmacy-based clinics to prescribe antivirals to anyone with Covid-19 who comes in for testing, because the clinic might not know the patient’s full medical history or other medications they’re taking, as a primary care physician would.
But on Saturday, the AMA said in another statement that the Biden administration has reassured the group “that patients who have access to a regular source of care should contact their physician shortly after testing positive for COVID-19 to assess their treatment options.”
“As the supply of antiviral medications for COVID-19 increases rapidly in the coming weeks and months, the AMA will continue to work to ensure that all patients, particularly historically marginalized groups, have safe and timely access to appropriate treatments.”
Why not prescribe treatments through the usual avenues?
The test-to-treat program “is critical to expanding access to these therapies by co-locating testing, test results and therapeutic prescriptions. It’s a really important step and one that we’re really excited about,” Dr. Cameron Webb, senior policy adviser for equity on the White House’s Covid-19 response team, told CNN on Monday.
Typically, a person who has been diagnosed with Covid-19 would be prescribed treatment through their primary care physician.
And according to HHS, “People will also continue to be able to be tested and treated by their own health care providers who can appropriately prescribe these oral antivirals at locations where they are being distributed.”
But one of the main goals of the test-to-treat program is to give more people more access to those treatments, as many might not have a primary care provider who can quickly test and treat them for Covid-19, Webb told CNN.
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“One of the really important pieces of this initiative is it helps create for them a pathway to get access to these therapeutics, and to do so through an appropriate prescriber as per the FDA,” Webb said, adding that under the emergency use authorization of the treatments, prescribers can be physicians, nurse practitioners or physicians’ assistants.
“Of course, for folks who do have a primary care provider and they’re able to get in touch with them, by all means, absolutely reach out to your provider, the person who knows you really well,” Webb said. “When you center a program in equity, you realize that not everybody is in that situation.”