https://immattersacp.org/weekly/archives/2022/06/28/2.htm

Oral medications for COVID-19 underused among socially vulnerable, CDC study finds

By late May, the rate of prescriptions for molnupiravir and nirmatrelvir/ritonavir was twice as high in the highest-income U.S. ZIP codes as in the lowest, research showed. A CDC webinar on June 28 will discuss efforts to equitably distribute these treatments.


The oral antivirals for the treatment of COVID-19 are not reaching enough of the most socially vulnerable Americans, according to recent data from the CDC.

The agency analyzed more than a million prescriptions for molnupiravir (Lagevrio) (n=248,838) and nirmatrelvir/ritonavir (Paxlovid) (n=827,924) from Dec. 23, 2021, through May 21, 2022, by whether they were dispensed in ZIP codes classified as low, medium, or high social vulnerability. Approximately 20% of U.S. residents live in low, 31% in medium, and 49% in high social vulnerability ZIP codes, according to the study, which was published by MMWR on June 21.

From March 6 to May 21 (the period when most of the antivirals were dispensed), the number of prescriptions per 100,000 population increased in all three types of ZIP codes, but by less in more vulnerable ZIP codes (from 3.3 to 77.4 in low, from 4.5 to 70.0 in medium, and from 7.8 to 35.7 in high). This was despite the fact that as of May 21, almost half the dispensing sites were in high-vulnerability ZIP codes: 18,844 (47.5%) compared with 13,072 (32.9%) in medium-vulnerability ZIP codes and 7,771 (19.6%) in low-vulnerability ZIP codes. Overall, during Dec. 23, 2021, to May 21, 2022, the drugs were dispensed at the highest rates in low-vulnerability ZIP codes (373.3 per 100,000), followed by medium (359.5) and high (287.4).

“The findings in this report highlight an ongoing need to identify and eliminate barriers to oral antiviral access, particularly within socially and economically disadvantaged communities. Timely administration of oral antivirals depends on multiple factors, including adequate drug supply and distribution; acceptance of the therapy by health care providers and the public; and patient access to testing, prescriptions, and drug dispensing sites,” the study authors wrote. They suggested consideration of strategies that would provide patients access to testing, clinical assessments, and oral antivirals in a single visit.

An analysis of the effectiveness of nirmatrelvir/ritonavir was also published by MMWR on June 21. It used data from a California health care system to assess hospital admissions and ED encounters related to SARS-CoV-2 among 5,287 patients who took nirmatrelvir/ritonavir. In the five to 15 days after treatment, there were six hospitalizations and 39 ED visits, representing less than 1% of the study population.

More information about the antivirals for COVID-19 and efforts to equitably distribute them will be available in an upcoming webinar from the CDC Foundation and Vaccine Equity Cooperative. “The Who, What, Where and When of COVID-19 Treatments: Everything You Need to Know About Lifesaving Antivirals” will be presented at 3 p.m. Eastern on June 28. Registration is online.