Recommendations for Ensuring Equitable Access to Oral Therapies for Treating COVID-19

Many hospitals and health departments are experiencing the greatest strain on their systems and workforce since the COVID-19 pandemic was declared nearly two years ago. As the Omicron wave approaches its peak, two new oral antiviral regimens effective at treating COVID-19 on an outpatient basis have become available but are in extremely short supply. We are concerned that the scarce supply of these new oral therapies could worsen health disparities that have persisted during the pandemic unless there is close monitoring to ensure equitable distribution.

To promote health equity and effective use of oral COVID-19 therapies, we urge states and local jurisdictions to consider the following criteria in their decision-making regarding the allocation of the limited supply of COVID-19 antiviral pills:

• Given the scarcity of new oral therapies authorized for treating COVID-19, it is important that the limited supply of both oral medication regimens is distributed equitably to sites within states and jurisdictions serving, or accessible to, uninsured individuals; Black, Indigenous and other people of color; immigrants; and other historically underserved populations. 
• Many safety-net health systems serve as an important access point for underserved populations in their city or county and should be considered as distribution sites.
• Community health centers and skilled nursing facilities are also critical access points for reaching underserved populations and should be a part of state distribution plans.
• Distributing primarily through retail pharmacies can create barriers to populations already more likely to experience disparities because pharmacies may request or require identification and health insurance information for services. In addition, individuals without a health care provider to prescribe the medications will face challenges accessing treatment unless there are alternative options for connecting with a prescribing clinician.
• All distribution sites should offer accessibility via a drive-thru or another means that limits exposure to others.

Although we have a limited supply of therapies effective at reducing serious illness and death due to the COVID-19 Omicron variant, we can take steps to maximize their benefit by distributing them to those in greatest need, guided by principles of equity and inclusivity.

-- Daniel P. McQuillen, MD, FIDSA – President, Infectious Diseases Society of America
-- Marwan Haddad, MD, MPH – Chair, HIV Medicine Association