Recently published study in the JAMA Health Forum among patients enrolled in Medicare in 2022 found that those with the highest risk of severe COVID-19 infection received COVID-19 therapy less frequently than those with the lowest risk.
“We set out to investigate why uptake of effective COVID-19 treatments for high-risk individuals in the United States has been so low,” says the study’s senior author. Michael L. Barnett, MD, PhD Assistant Professor of Health Policy and Management at the Harvard School of Public Health. T.C. Chana. “Our first task was to identify the people who were using it.”
“When we looked at the different risk factors for COVID-19, people at the highest risk should receive treatment 5 to 10 times more often than people with lower risk factors,” said senior study author Dr. Michael L. Barnett, assistant professor. , Health Policy and Management, Harvard T.H. School of Public Health. T.C. Chana. “But our results showed the opposite.”
Free treatment for people at high risk of contracting COVID-19
Barnett and the research team were surprised by the results. “We have free, safe outpatient treatment for COVID-19 that is very effective for people at risk of severe COVID-19 infection, and it is largely underutilized in the United States.” brand name Paxlovid.
The study found that if the high-risk patients in their sample had received Paxlovid, 16% of the COVID-19 deaths in their study could have been prevented, Barnett says.
The results also showed that some high-risk Medicare beneficiaries were less likely to receive treatment than other patients, depending on race, age, and income. Black patients were significantly less likely to receive treatment than white patients (3% vs. 6.4%), as were patients over 90 years of age and Medicaid-eligible patients.
Education can improve treatment effectiveness
Barnett and his team believe education is key to helping high-risk COVID-19 patients.
“There needs to be a broader public awareness campaign,” Barnett says. “Older adults with chronic conditions bear a highly disproportionate burden, and many are unaware of treatment options.”
Another potential problem, Barnett said, is that patients may shy away from the drug because of the long list of other drugs that have drug interactions. For the same reason, doctors may also hesitate to prescribe the drug.
“We haven’t done a very good job of communicating to primary care providers and physicians how often and under what circumstances we should actually use this drug,” Barnett says.
Most drug interactions can be managed, he said. “For a week or two, many medications can be easily skipped to reap the benefits of Paxlovid.” One example is cholesterol-lowering drugs (statins). Stopping the drug for a week or two would justify Paxlovid’s benefits against COVID, Barnett said.
However, other medications, such as blood thinners, pose a greater risk if they are stopped. “Most patients taking blood thinners can simply reduce their Paxlovid doses. But some people taking blood thinners may not be good candidates for Paxlovid, says Barnett.
Additionally, Barnett says, patients need to be educated about when Paxlovid is useful. “To benefit from Paxlovid, patients must take steps to resolve COVID-19 symptoms for five days.”