Thu. Sep 28th, 2023

Noting that MinuteClinics tend to be located in affluent areas, he said of the test-to-treat program: “In terms of expanding access, it hasn’t done what it could do, particularly in medically underserved areas.”

Use of Paxlovid has exploded in recent weeks in Vermont as cases have climbed there, a trend that can be attributed to growing awareness of the drug, said Dr. Mark Levine, the state’s top health official. But he said that Vermont, which has high rates of patients with both health insurance and primary care providers, would not benefit from a system like test-to-treat as much as others.

“Test-to-treat is most ideal for where you have the most trouble connecting people with health care,” said Dr. Levine. “Generally those places don’t have as much capacity in primary care systems, or don’t have a highly insured population.”

Even though Paxlovid is free, uninsured patients and people with high-deductible plans who seek a prescription from a pharmacy clinic or urgent care center can get socked with consultation charges.

Amanda Fuller Moore, a pharmacist in North Carolina’s Department of Health and Human Services, said uninsured people in her state were rightly concerned about charges they could encounter while seeking a test or prescription, “especially in a setting where it can difficult to figure out what that charge might be.”

“That makes them even more reluctant to seek” Paxlovid, she said.

Officials in New York City began a program over the winter that relieved some of the pressures, delivering the pills directly to homes for free, a move that earned praise from White House officials.

But some Americans are stuck without easy access to any health provider, putting more pressure on rural states to deliver the treatment efficiently. George Gerhardt, a North Dakota health official, said the state keeps a reserve supply of the medication in case of an outbreak or shortage. The state does not have a CVS MinuteClinic, and has just a few test-to-treat locations, he said.

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