Oral COVID-19 medications have shipped, but good luck getting a prescription in Pennsylvania

The antivirals stop the virus from replicating, so they work best if given to COVID-19 patients who are early in their illness when their symptoms are still mild.

  • Sarah Boden/WESA

(Pittsburgh) — Fewer than 20 pharmacies in southwestern Pennsylvania have received shipments of the oral COVID-19 antiviral medications.

Both Pfizer’s Paxlovid and Merck’s molnupiravir received emergency use authorization from the Food and Drug Administration last month. The federal government has purchased these medications, so they’re free to the public, though insurers might charge an administration fee.

The antivirals stop the virus from replicating, so they work best if given to COVID-19 patients who are early in their illness when their symptoms are still mild. Nationwide, supplies are very limited, and with the ongoing surge of the highly infectious omicron variant, it’s likely that only the most at-risk patients will receive these medications.

“There are two groups that are most important: the ones that are the unvaccinated people with high risk, and the immunosuppressed people,” said Dr. Pablo Tebas, an infectious disease expert at the University of Pennsylvania.

Because the groups that Tebas mentioned are rather large, he said other risk factors like age might also be considered.

Tebas made his comments during a Tuesday panel hosted by Pennsylvania’s physician general Dr. Denise Johnson, who said that physicians would have to decide which patients needed these medications the most.

“The companies are working on production to ramp those up,” said Johnson. “But I don’t think we have any good timeline on when we will have much more of the supply.”

Asti’s South Hill Pharmacy is one of just seven pharmacies in Allegheny County that can fill prescriptions for these oral COVID-19 antiviral medications. Owner Chris Antypas said his Mt. Lebanon pharmacy received enough Paxlovid doses for 40 patients on New Year’s Eve.

“We’ve had a few calls today, but I don’t think we’ve actually received our first prescriptions yet. The prescribers are just getting comfortable writing an order for it,” said Antypas, who predicts the medication will go pretty fast due to the ongoing surge of the highly infectious omicron variant.

Asti is also scheduled to receive molnupiravir, though Paxlovid is far more effective at reducing someone’s chances of hospitalization and death.

The monoclonal antibody treatment also seems to produce better results than molnupiravir. Monoclonal antibodies are given as a one-time infusion, while both antiviral medications are five-day regimens where someone takes a daily pill while recovering at home.

The treatments each have their benefits and drawbacks. For example, Paxlovid is not recommended for those with severe kidney or liver disease, and Merck’s monlnupieravir should not be taken by pregnant people. Of the three monoclonal antibody drugs just one is effective against omicron, thus decreasing the availability of this treatment.

But as the University of Pittsburgh’s Dr. J. Ryan Bariola said, “Whichever one you can get access to, in most cases, is probably the one we want you to get.”

More importantly, Johnson, Tebas and Bariola all say that treatments should not replace COVID-19 vaccinations and boosters, since prevention is always more effective.

“This is a last resort,” said Tebas.

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