Covid pills are easier to find as the omicron surge subsides

The supply of Covid-19 antiviral pills is picking up in the country, state health departments and physicians say, as drug companies like Pfizer churn out more of the treatments.

In the initial weeks after their authorization late last year, the pills – hailed by some as a game-changer – were scarce and hard to come by. But now that the omicron surge has largely subsided and the supply of the drugs has increased, the pills are easier to access.

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As more supply becomes available, more people – especially those at higher risk – can live “a somewhat normal life without utmost fear of death, should they contract Covid,” said Dr. David Boulware, an infectious disease physician at the University of Minnesota Medical School.

Since the antiviral pills were authorized in December for mild to moderate Covid, the federal government has sent to the states more than 500,000 courses of Pfizer’s Paxlovid and about 1.8 million courses of Merck’s molnupiravir, according to data from the US Department of Health and Human Services .

The antivirals are “not in every drugstore, but they’re a little bit easier” to find now, said Dr. Gerald Harmon, president of the American Medical Association and a family physician in South Carolina.

He said only one pharmacy in his county had the Covid pills in stock last month, but now there are usually two or three pharmacies carrying them. Pill supplies were initially very limited, doctors had to hunt them down at pharmacies hours away or put the burden on sick patients to find the drugs themselves.

But deliveries of the drugs, which are meant to be taken early in the course of the disease and keep people out of the hospital, have gradually increased over several weeks, as the drugmakers ramped up production.

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The federal government has a deal with Pfizer for a total of 20 million courses of its treatment, with the first half expected by late summer. It also has a deal for 3.1 million courses of molnupiravir, which Merck said it completed this month.

The availability of the drugs, along with the Covid vaccines, may help the nation move “toward a time when Covid is not a crisis but is something we can protect against and treat,” Jeff Zients, the White House coronavirus response coordinator, said at a briefing last week.

Along with Eli Lilly’s recently authorized monoclonal antibody drug, bebtelovimab, there are now a handful of treatment options for Americans at the highest risk of severe illness from the omicron variant, including people with weakened immune systems who may not respond as well to vaccinations, Boulware said.

Expanding the eligibility

In Michigan, health officials are expanding the eligibility for the Pfizer drug, as supply has increased and Covid cases have fallen, said Lynn Sutfin, a spokesperson for the state Department of Health and Human Services.

Michigan health officials had initially limited the use of the Pfizer pill to immunocompromised people with moderate to severe illness, and people ages 75 and older who were not up to date on their Covid vaccines.

Sutfin said the state has since expanded its eligibility to include anyone ages 75 and older, and people as young as 65 who are not up to date on their Covid vaccinations and have an underlying health condition that puts them at risk for severe illness.

In Ohio, supply remains limited, but access has improved as more sites have received courses of treatment, and the state Department of Health has worked to increase public awareness, Ken Gordon, a spokesperson for the department, said.

Ohio has received 9,380 courses from Paxlovid, a “significant increase” from early January, he said.

Pills turned down?

Not every Covid patient is clamoring for the antivirals.

Dr. Stephen Schrantz, a clinical researcher and an infectious disease doctor who also sees patients at the Friend Health clinic in Chicago, said he often sees Covid patients turn down the pills.

People may turn it down because they “feel relatively OK early in the course of illness, when they are approached to start treatment,” he said. Most of the patients are unvaccinated, he added, and “do not trust new medications in a similar fashion.”

Dr. Rajesh Gandhi, an infectious disease specialist at the Massachusetts General Hospital in Boston, said he has not had patients turn down the pills, but some have asked whether the drugs are better than monoclonal antibodies.

The omicron variant rendered most antibody drugs in use in the United States ineffective. This month, however, the Food and Drug Administration authorized the new antibody drug, from Eli Lilly, that works against omicron. The Biden administration has purchased 600,000 doses, with about 300,000 courses expected to ship by the end of the month, and another 300,000 in March.

Both Pfizer and Merck have said their antiviral pills should work against the omicron variant.

“I think there’s still quite a bit of interest and enthusiasm” for either antibody or oral treatments, Gandhi said. “I’m talking about people in their 70s with kidney disease, with heart disease. These people know they are at high risk despite being vaccinated.”

Harmon, president of the American Medical Association, said he’s never had a patient decline the antiviral pills, especially if they are already experiencing symptoms. “My patients make every effort to take it,” he said.

Boulware, of the University of Minnesota, said the supply of the pills has “certainly improved.”

As the supply continues to increase, he said, there should be a push to allow people who aren’t at high risk of severe disease to take the medications.

Even though healthy vaccinated people who get infected with omicron are unlikely to end up in the hospital, “they can still feel terrible and end up being out of work for a week or two,” he said.

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