People of color with a COVID-19 diagnosis were much less likely to receive Paxlovid and other treatments than white patients, according to new data from the Centers for Disease Control and Prevention (CDC).
The findings are consistent across all age groups and underscore the persistent disparities surrounding access to COVID-19 treatments, especially the antiviral pill Paxlovid. Paxlovid is the most commonly prescribed medication and the preferred outpatient therapeutic for eligible patients, according to the CDC.
Paxlovid is available primarily for people who test positive for COVID-19 and are at high risk of developing serious illness, such as the immunocompromised or older patients. It's taken at home, and has been shown to significantly reduce hospitalization and death.
During a four-month period from April to July 2022, Paxlovid treatment was 36 percent lower among Black patients relative to White patients and 30 percent lower among Hispanic patients relative to non-Hispanic patients.
The largest difference was between Black and White patients aged 65 to 79, where white patients were 44 percent more likely to receive a Paxlovid prescription.
The study found disparities in other treatments — including antivirals molnupiravir and remdesivir, as well as the monoclonal antibody bebtelovimab — but they were much less frequently prescribed than Paxlovid.
The study did not assess why the disparities were so striking, but researchers suggested multiple factors, including that people living in counties that are both high-poverty areas and majority minority are less likely to have access to COVID-19 treatment facilities.
In addition, minority patients’ previous negative experiences with health care services could influence their decisions regarding use of treatments, or racism and implicit biases among health care providers might also have contributed to treatment disparities.
Paxlovid is only available by prescription, and must be taken within five days of a patient first showing symptoms. That compressed timeline can make it difficult for patients to access it in a timely manner.
A number of states and cities have launched free "Test-to-Treat" programs, an initiative the federal government launched in May to help build equitable access to COVID-19 treatments. The program allows people with COVID-19 symptoms to get tested, be prescribed antiviral pills, and fill the prescription all in one visit.
But if a patient's community doesn't have such a program, then a doctor's appointment is still needed in order to get a prescription, which can take time and money many low-income minority patients don't have.
Equity is especially important as the federal government moves to end federal purchase and distribution of vaccines and treatment, shifting it all to the commercial marketplace.
According to a recent Kaiser Family Foundation analysis, the commercialization of COVID-19 treatments, tests and vaccines would create substantial access barriers for the uninsured and underinsured unless the government builds in protections.
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