Last Tuesday just after 1pm, my phone buzzed with a text message from my mom: “Well, I’ve had a cold, pain, cough, etc. over the course of the week.” She had done a corona test at home. It was positive.
Having written about Covid-19 vaccines and treatments for The New York Times over the past year, I knew a lot about the options available to people like my mother. Still, I was about to embark on a seven-hour odyssey that would show me there was much I didn’t understand.
My mother, Mary Ann Neilsen, has been fully vaccinated, including a booster shot, which greatly reduced the chances of her becoming seriously ill with the virus. But she has several risk factors that concern me. She is 73. She has overcome breast cancer twice.
Her age and cancer history made her eligible for the latest treatments that have been shown to prevent the worst effects of Covid. The problem, as I knew from my reporting, was that these treatments — including monoclonal antibody infusions and antiviral pills — are hard to come by.
Demand for the drugs rises as the Omicron strain of the coronavirus infects record numbers of Americans. But supplies are scarce. The two most commonly used antibody brands don’t seem to work against Omicron, and the antiviral pills are so new and developed so quickly that not many hospitals and pharmacies have reached them.
I went looking for one of two treatments: GlaxoSmithKline’s antibody infusion or Pfizer’s antiviral pills known as Paxlovid. Both have been shown to be safe and highly protective against severe Covid when given to high-risk patients within days of the onset of symptoms. Both are powerful against Omicron.
One of my first steps was to search online for lists of pharmacies and clinics near my mother’s home in Santa Barbara, California that might stock one of the drugs. (I live in Washington State, so my search, like so many others these days, was conducted remotely.)
Some states, such as Tennessee and Florida, have helpful online tools for finding a monoclonal antibody facility in stock. But I couldn’t find one for California. I checked a federal database, which had only one entry within 40 miles of my mother.
When I called that health system, I was told it had run out.
I also hunted Paxlovid. From my reporting, I knew of a federal database of pharmacy chains, hospital systems, and other providers who have placed orders for the pills. A Times colleague downloaded the data, as anyone can do, and sent it to me in a more easily searchable format.
The list only turned up a few options, mostly pharmacies, near my mom. I called the nearest one, a CVS, but an employee told me the store had quickly run out of the first batch of pills and didn’t know when more would come.
After a few more phone calls, I found a Rite Aid, over an hour’s drive from my mother’s apartment, which Paxlovid had in stock. The pharmacy warned me that the delivery was fast.
Still, this was good news. I thought I had just overcome the toughest obstacle, and only two hours had passed since my mother tested positive. Now all I had to do was get her a prescription.
I had already asked my mother to call her doctor’s office and call her doctor so she could get a prescription for one of the treatments. She told me that the receptionist had told her that they “don’t do” the Glaxo or Pfizer treatments.
January 19, 2022, 2:31 PM ET
That didn’t seem logical to me: the Food and Drug Administration has approved the drugs. Why shouldn’t doctors prescribe them? Frustrated, I called her doctor’s office to get an explanation. (I didn’t identify myself as a Times reporter in that phone call or the others I made that day, partly because I didn’t want to appear to be seeking preferential treatment.)
The employee who answered the phone told me that the doctors there had yet to conduct their own medical assessment of Paxlovid and could not prescribe it out of policy yet. In addition, the employee told me that my mother needed an appointment to speak with a doctor and that there was not time until a week later.
I began to hunt for another doctor who would immediately write out a prescription.
I’ve tried scheduling visits with several telemedicine providers, including CVS and Teladoc, but I kept seeing a message in the same wording on the intake forms: They didn’t write prescriptions for Paxlovid or molnupiravir, a similar antiviral pill from Merck.
(Later, I asked both companies about these policies. A CFS spokeswoman said providers prescribed the antiviral pills to patients they saw in person in some stores, but not through telemedicine. A Teladoc spokesperson said the company believed at this point that ” the most convenient” to prescribe the antiviral pills in person.)
I started calling urgent care clinics and health systems near my mother to see if they would prescribe her a prescription. At one point, we even got her on a video call with a doctor from a nearby health system.
The coronavirus pandemic: important things to know
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Free tests and masks. The Biden Administration’s new website that allows any U.S. household to order up to four free home coronavirus tests is live. President Biden is also expected to announce the shipment of 400 million free N95 masks, which will be available at health centers and pharmacies across the country.
Funnily enough, we were repeatedly told the same thing: their doctors could not write prescriptions for Paxlovid during virtual appointments. My mother should be personally assessed – seemingly negating the purpose of a remote doctor’s appointment.
In any case, this was a non-starter, as my mother lives alone and does not drive, and the clinics were not within walking distance. She would not consider taking a taxi or bus and risk exposing others to the virus. My mother is not alone in that regard. Tens of millions of Americans depend on public transportation. And those with cars are at risk of spreading the virus as they personally search for prescriptions.
Other medical facilities I called that afternoon gave me information that was simply wrong. One person told me that there were no monoclonal antibody treatments available in California. Another insisted that Paxlovid was only for hospitalized patients.
In the end, my struggle to find a prescriber proved unnecessary. In the early evening, my mother received an unexpected call from a doctor with her primary care provider. She told the doctor about her symptoms and about the Rite Aid I found with Paxlovid in stock.
The doctor told her he was surprised we were able to track down Paxlovid. He called the Rite Aid with a prescription.
Now all we had to do was pick up the pills before the pharmacy closed in about an hour.
Uber came to the rescue. I requested a pick up at the Rite Aid and listed the destination as my mother’s house about 60 miles away.
When a driver accepted the ride, I called him and explained my unusual request: he should get the prescription from the pharmacy and then drive it to my mom. I told him I would tip him 100 percent.
The driver, who asked me not to use his name in this article, was wild. He delivered the precious cargo just after 8 p.m. My mother took the first three pills – the start of a five-day regimen of 30 pills – within minutes of the driver’s arrival.
“I’m on meds and I’m very grateful to have them,” she texted in the family group chat.
By some measures my search was successful. My mom didn’t start taking the pills until two and a half days after her symptoms started and within eight hours of testing positive.
Within a few days she started to feel better. She completed the regimen this past weekend.
But the fact that the process was so difficult for a journalist whose job it is to understand how Paxlovid is delivered is not encouraging. I worry that many patients or their families would give up if they said ‘no’ as often as I did.
I was also reminded that even a “free” treatment can come at a significant cost.
The federal government has bought enough Paxlovid for 20 million Americans, at a cost of about $530 per person, to be distributed for free. But I spent $256.54 to get the pills for my mom. I paid $39 for the telemedicine visit with the provider who told my mother to come in person. The rest was the Uber fare and tip. Many patients and their families cannot afford that.
President Biden recently called the Pfizer pills a “game changer.” My experience suggests it won’t be that simple.
This post Searching for Pfizer’s Paxlovid Pills When Mom Got Covid
was original published at “https://www.nytimes.com/2022/01/19/business/covid-pill-treatment-pfizer.html”