COVID-19 Data Dispatch

Tag: health equity

  • Paxlovid will be far more expensive and covered by private insurance in 2024, likely leading to access issues

    Paxlovid will be far more expensive and covered by private insurance in 2024, likely leading to access issues

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    Starting in 2024, the antiviral drug Paxlovid will be a private—and expensive—treatment for COVID-19. The Department of Health and Human Services (HHS) announced about a week ago that it’s reached a deal with Pfizer, the pharmaceutical company that produces Paxlovid, to “transition” this drug into the commercial market within the next few months. The transition will lead to Paxlovid becoming even less accessible than it is now and will exacerbate health inequities that we’ve seen with this drug. 

    A few days ago, news outlets reported that Pfizer will charge about $1,400 per course as the list price for Paxlovid upon this transition. This is about double the price that HHS previously paid for the drug, which was about $530 per course.

    HHS previously purchased about 24 million courses of Paxlovid, of which about 17 million have been distributed and 11 million have been administered, according to the agency’s data. Under the privatization agreement, HHS will return about 8 million courses back to Pfizer, which will serve as a credit for covering continued free supply to people who have Medicare, Medicaid, or who are uninsured.

    According to HHS, people who have public insurance or no health insurance should continue to receive free Paxlovid through the end of 2024. And after that, Pfizer will run a patient assistance program for people who are uninsured or underinsured. Still, the transition is likely to cause health equity issues, as people who have public insurance or no insurance will have to jump through more hoops to receive free Paxlovid under these programs, as opposed to the current situation where everyone can get it for free. We’ve all seen how chaotically this fall’s vaccine rollout went, after all.

    The HHS’s data for Paxlovid administration (shown above) demonstrate that states where healthcare is more easily accessible and/or where patient populations are wealthier tend to have higher rates of receiving Paxlovid over the nearly two years that it’s been available. We also know from scientific studies looking at Paxlovid that this drug has followed access issues similar to the COVID-19 vaccines and tests.

    Considering these prior patterns, combined with the increasing price, it unfortunately seems like a foregone conclusion that Paxlovid will get harder to access in 2024. This will be a huge issue for preventing severe disease and death from COVID-19 as well as limiting risks of Long COVID, which research suggests Paxlovid can do as well.

    If you are a reader who’s had a hard time getting Paxlovid, or if you want to share more comments or questions on this issue, please reach out.

    more federal data
  • Ending emergencies will lead to renewed health equity issues

    Ending emergencies will lead to renewed health equity issues

    The header image from a story I recently had published in Amsterdam News about declining access to COVID-19 services.

    Last week, I gave you an overview of the changes coming with the end of the federal public health emergency (PHE), highlighting some shifts in publicly available COVID-19 services and data. This week, I’d like to focus on the health equity implications of the PHE’s end.

    COVID-19 led the U.S. healthcare system to do something unprecedented: make key health services freely available to all Americans. Of course, this only applied to a few specific COVID-related items—vaccines, tests, Paxlovid—and people still had to jump through a lot of hoops to get them. But it’s still a big deal, compared to how fractured our healthcare is for everything else.

    The PHE allowed the U.S. to make those COVID-19 services free by giving the federal government authority to buy them in bulk. The federal government also provided funding to help get those vaccines, tests, and treatments to people, through programs like mass vaccination sites and mobile Paxlovid delivery. Through these programs, healthcare and public health workers got the resources to be creative about breaking down access barriers.

    Now that the emergency is ending, those extra supplies and resources are going away. COVID-19 is going to be treated like any other disease. And as a result, people who are already vulnerable to other health issues will become more at risk for COVID-19.

    I wrote about this health equity problem in a recent story for Amsterdam News, a local paper in New York City that serves the city’s Black community. The story talks about how COVID-19 services in NYC are changing with the end of the PHE, and who will be most impacted by those changes. It’s part of a larger series in the paper covering the PHE’s end.

    Most of the story is NYC-specific, but I wanted to share a few paragraphs that I think will resonate more widely:

    Jasmin Smith, a former contact tracer who lives in Brooklyn, worries that diminished public resources will contribute to increased COVID-19 spread and make it harder for people with existing health conditions to participate in common activities, like taking the subway or going to the grocery store.

    COVID-19 safety measures “make the world more open to people like myself who are COVID-conscious and people who might be immunocomprmised, disabled, chronically ill,” Smith said. “When those things go away, your world becomes smaller and smaller.”

    The ending federal public health emergency has also contributed to widespread confusion and anxiety about COVID-19 services, [said Dr. Wafaa El-Sadr, a professor of epidemiology and global health at Columbia University’s Mailman School of Public Health]. “People have so many questions about this transition,” she said, and local leaders could do more to answer these questions for New Yorkers.

    The near future of COVID-19 care in the U.S. could reflect existing health disparities for other endemic diseases, like the seasonal flu and HIV/AIDS, [said Steven Thrasher, a professor at Northwestern University and author of the book, The Viral Underclass]. For example, people with insurance and a primary care physician are more likely to get their annual flu shots, he said, while those without are more likely to face severe outcomes from the disease.

    After May 11, COVID-19 outcomes are likely to fall along similar lines. “More people have died of AIDS after there were HIV medications,” Thrasher said. “More people have died of COVID when there were vaccines in this country than before.”

    For more news and commentary on COVID-19 emergencies ending, I recommend: