National Study Finds Low Uptake of COVID-19 Oral Antivirals

Feb. 21, 2024
Boxes of Paxlovid in a warehouse

A study conducted by CUNY SPH investigators in the Institute for Implementation Science in Population Health examined the uptake of oral COVID-19 antivirals, specifically nirmatrelvir/ritonavir (NMV/r, also known as Paxlovid), and molnupiravir (MOV), among a highly vaccinated adult cohort (n=1,622) in the United States who were infected with SARS-CoV-2 from December 2021 to October 2022.

Despite the availability and proven effectiveness of these antivirals in preventing severe COVID-19 outcomes, the study found that uptake was low. NMV/r was taken by 13.6% of participants, while MOV uptake was even lower at 1.4%. The study observed an increase in NMV/r uptake over time, with older adults and those with comorbidities showing higher rates of use. However, uptake was significantly lower among non-Hispanic Black participants and individuals in lower income brackets.

Among participants who did use NMV/r, a majority found it helpful in reducing COVID-19 symptoms. Despite being eligible for antiviral prescriptions based on FDA guidelines, many did not receive treatment, highlighting a gap between eligibility and actual uptake.

“It’s deeply concerning to see a low uptake of COVID-19 oral antivirals on a national scale. Oral antiviral treatments offer the potential to significantly reduce the severity of illness and save lives, particularly for vulnerable populations. A failure to prioritize and promote their uptake risks prolonging the crisis and exacerbating its toll on lives and livelihoods,” says PhD candidate Jenny Shen, the paper’s first author. “Urgent action is needed to understand and remove systemic barriers, enhance public education to increase awareness about the effectiveness and availability of these treatments, and ensure equitable access to these life-saving medications.”

Additionally, notes Shen, further studies are warranted to examine the impact of the U.S. government’s shifting COVID-19 oral antivirals to the commercial market in November 2023, which might risk undermining public health efforts and could result in unnecessary suffering and loss of life.

Shen, Y., Robertson, M. M., Kulkarni, S. G., Puzniak, L., Zamparo, J. M., Allen, K. E., Porter, T. M., Qasmieh, S. A., Grov, C., Srivastava, A., Zimba, R., McLaughlin, J. M., & Nash, D. (2023). Oral COVID-19 Antiviral Uptake Among a Highly Vaccinated US Cohort of Adults With SARS-CoV-2 Infection Between December 2021 and October 2022. Open forum infectious diseases11(2), ofad674.