When Mike Moersen tested positive for COVID-19, he was dealing with a nasty cough, post-nasal drip, and body aches, so he called his doctor, looking for anything that would help remedy his symptoms. He was prescribed Paxlovid –– the Pfizer-manufactured drug that helps COVID patients recover faster from their sickness, and prevent it from worsening.
Confined to his bed, he asked his wife to pick up the treatment from their local Thousand Oaks CVS pharmacy. But soon, he was hit by another surprise.
“[My wife] goes, ‘They want $1,100,” he recalls. “I said, ‘Forget it. I will gut it out for a couple days.”
Moersen recovered just a few days later without the need for Paxlovid, but many others have been reeling from the high cost of the treatment.
This issue stems from a change in how Paxlovid is delivered to patients. Prior to November, the federal government procured the treatment directly from Pfizer and provided it to the public for free.
Now, Paxlovid has entered the commercial market, and the price of the drug is determined by its manufacturer, like many other medications. Pfizer set the cost for one round of Paxlovid at $1,400, and the final out-of-pocket expense is determined by whether the COVID remedy is covered by insurance.
Paxlovid isn’t covered by Medicare, the health insurance Moersen uses. But in anticipation of this sudden price hike, the Department of Health and Human Services set up a program ensuring that people with Medicare could still get Paxlovid for free through 2024.
However, to get the savings, qualifying patients needed to proactively enroll in the program –– and some didn’t even know that it exists.
“I was not made aware of [this program]. Nobody said anything about it,” Moersen says.
Even doctors who are well-versed in public health are having trouble finding information about the program.
“It’s not something that I’ve heard on the radio, or seen on TV, or read about on social media,” says Dr. Peter Chin-Hong, a UCSF researcher who studies the spread of COVID.
Health officials have had behind-the-scenes meetings with health care leaders to communicate information about the program. Earlier this month, DHHS Secretary Xavier Becerra met with pharmacy CEOs to stress the importance of pharmacist education to patients about affordable Paxlovid options.
Pharmacists say they’re doing their part, and that the entire health care ecosystem should also be working to get the word out.
“I think it’s multiple parts in the chain that need to make sure that we’re all aware that these options do exist,” says Brigid Groves, a senior staffer with the American Pharmacists Association. “So I don’t think it solely relies on the pharmacist. … We all need to make sure we’re doing our due diligence together.”
Dr. Chin-Hong attributes the communication difficulties to the “patchwork” American health care system –– which requires drug manufacturers, doctors, pharmacists, and insurers to work together to inform the public. But even if there were clearer messaging about the program, Chin-Hong says he has concerns about adding the extra step into the access of the drug.
“If there’s so many barriers, or even if there’s one barrier, people may not be motivated to get [Paxlovid],” Dr. Chin-Hong says. That could lead to deaths and chronic effects from COVID that could have been prevented.
