Top 5 Takeaways

1. Lagevrio and Paxlovid showed effectiveness in preventing hospitalization and death. These oral antiviral drugs have been crucial for patients with mild to moderate COVID-19 who are at risk for progression to severe disease when initiated within 5 days of symptom onset.
2. Disparities in dispensing rates across zip codes. Despite over a million prescriptions being dispensed, high social vulnerability zip codes had significantly lower dispensing rates compared to those with medium and low social vulnerability.
3. Increase in oral antiviral dispensing sites. The study period saw a substantial increase in the number of dispensing sites to 39,687, with most being pharmacies, yet this did not equitably increase access in high-vulnerability communities.
4. Challenges in access for high-vulnerability communities. Despite high vulnerability zip codes having the largest number of dispensing sites, barriers to access, such as the lack of on-site prescribers, remain significant.
5. Call for additional public health efforts. The report highlights the need for innovative strategies to decrease barriers and improve access to oral antiviral medications, particularly in socially and economically disadvantaged communities.

Original Article Author and Citation

Corresponding Author

Jeremy A.W. Gold, jgold@cdc.gov.

Suggested Citation

Gold JA, Kelleher J, Magid J, et al. Dispensing of Oral Antiviral Drugs for Treatment of COVID-19 by Zip Code–Level Social Vulnerability — United States, December 23, 2021–May 21, 2022. MMWR Morb Mortal Wkly Rep 2022;71:825-829. DOI: http://dx.doi.org/10.15585/mmwr.mm7125e1.

Summary

The study details the dispensing of Lagevrio and Paxlovid, oral antiviral drugs for COVID-19, across the United States, focusing on the disparities in access among communities of varying social vulnerabilities. Despite overall increases in the number of antivirals dispensed and dispensing sites, high-vulnerability zip codes experienced lower dispensing rates, underlining the need for targeted public health interventions.

Methods

Data from December 23, 2021, to May 21, 2022, were analyzed to assess the distribution of oral antiviral prescriptions based on the zip code social vulnerability. The Equitable Distribution Index scale was used to classify zip codes into low, medium, and high social vulnerability. Rates of dispensing were calculated using population figures from CDC data.

Discussion

The findings emphasize the challenge of ensuring equitable access to COVID-19 treatments. Despite efforts to increase access, high-vulnerability communities remain at a disadvantage. The lack of on-site prescribers at dispensing locations and the end of certain reimbursements may contribute to these disparities.

Conclusion

The study calls for increased efforts to address the barriers to accessing oral antiviral drugs, especially in high-vulnerability communities. Strategies suggested include enhancing access to testing, prescriptions, drug dispensing sites, and considering provider reimbursements to facilitate patient access.

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