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Paxlovid, other COVID-19 treatments remain largely inaccessible to many in Durham

As the federal government works to expand access to antiviral COVID-19 treatments prior to hospitalization, The Chronicle looked into the availability of treatment at Duke and in Durham.

As of May 30, the only antiviral treatments authorized to treat mild to moderate COVID-19 are Pfizer’s Paxlovid and Merck’s Lagevrio (also called molnupiravir). Antibody treatments for severe disease include Evusheld and bebtelovimab

The U.S. plans to allow more pharmacies to order these treatments and expand the test-to-treat program, in which someone can get tested for COVID-19 and obtain treatment in the same visit.

Alexis Porter, senior media relations strategist for the Duke Health news office, said the University’s health system does not plan to participate in the test-to-treat program, meaning a prescription is the only way to acquire treatment at Duke.

Student Health Director John Vaughn wrote in an email to The Chronicle that while Student Health clinicians can prescribe oral medications for COVID-19, most students don’t meet treatment criteria. 

According to the FDA, those receiving oral treatment must display “one or more risk factors for progression to severe COVID-19.” As of Feb. 15, the Centers for Disease Control and Prevention identify people with certain health conditions—including cancer, certain chronic diseases, immunodeficiencies, learning disabilities and mental health disorders—as being at higher risk for severe COVID-19 outcomes.

“Because of previous supply issues and the infrequency with which Student Health prescribes [oral COVID-19 medications], the Duke Campus Pharmacy is not currently carrying it in stock, but the medication could be obtained from the Duke Clinic Pharmacy in the Duke South clinic building if needed,” Vaughn wrote.

In addition to limited prescription eligibility, access remains a challenge. While some states have allowed patients to obtain Paxlovid through telehealth visits, this is not practiced everywhere.

Patients who have experienced recurrent symptoms after finishing their five-day Paxlovid course have had problems getting second prescriptions. Pfizer recently said Paxlovid can be used again if one’s viral load increases again following treatment. The FDA, however, said that there is no evidence of additional benefit from a longer course of treatment or a repeated course following recurrent symptoms.

In April, WRAL reported that North Carolina had only dispensed 28% of its Paxlovid supply and 15% of its Lagevrio supply. 

The only pharmacies in Durham that are participating in the federal test-to-treat program are four CVS locations.

Below is a map of places to potentially pick up a prescription, which can be filtered by type of treatment. The data originates from the Department of Health and Human Services, which compiles the most recent self-reported information available.

Nadia Bey | Digital Strategy Director

Nadia Bey is a Trinity senior and digital strategy director for The Chronicle’s 118th volume. She was previously managing editor for Volume 117.


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