Los Angeles Times

Accessing COVID pills

More availabili­ty helps those who test positive for virus to get timely treatment.

- By Rong-Gong Lin II and Emily Alpert Reyes

If you test positive for the coronaviru­s and are at high risk, how can you get access to anti-COVID drugs?

The medication­s are becoming increasing­ly available, and there is no longer a shortage of the drugs in most locations, California health officials say.

Here’s what you should know.

‘Test-to-treat’ sites

It’s important to know your coronaviru­s test status early in the infection and seek drugs promptly.

Those who have a regular health provider can ask for a prescripti­on. The U.S. government also has set up “test-to-treat” sites, which are meant to allow people to get tested and obtain free anti-COVID pills at the same location, such as a pharmacy or clinic, as long as staff can either conduct a coronaviru­s test or evaluate an at-home result and have on-site healthcare providers who can assess the patient.

A list of sites offering testto-treat services in Los Angeles County can be found at ph.lacounty.gov/ covidmedic­ines or by calling the county Department of Public Health at (833) 5400473 between 8 a.m. and

[Treatment, from B1] 8:30 p.m. daily. They include CVS and Walgreens locations, as well as hospitals, clinics and pharmacies.

Test-to-treat sites outside L.A. County can be found at aspr.hhs.gov/ TestToTrea­t.

In L.A. County, public health officials have recommende­d that people seeking test-to-treat services call ahead to check that medication­s are in stock. Some sites require appointmen­ts; others accept walk-ins. Patients also should ask about administra­tion fees, the public health department said.

To get medication, people can either get tested on site or bring proof of a positive resultwith them. They also need to be prescribed the medication by a provider. Some sites have a provider on site, while others use telehealth visits.

L.A. County also is offering its own telehealth services to help prescribe antiviral medication­s to those who are eligible, said Dr. Franklin Pratt, a senior physician with the public health department.

“We have to do an electronic prescripti­on, and then they go to the pharmacy and pick it up,” he said. Patients can be connected with that service by calling (833) 540-0473 between 8 a.m. and 8:30 p.m. seven days a week. An L.A. County resident with a positive test also can get drugs mailed to them at no cost by calling the same number.

Because there is a short window when COVID-19 patients can be prescribed oral antivirals, Pratt urged people to reach out promptly if they have symptoms.

“Please, please come in as soon as you develop symptoms. Because once we hit Day 6” — six days after symptoms begin — “we can’t give you the oral antivirals and we have to use different treatments that are logistical­ly more difficult and involve intravenou­s medication,” Pratt said.

Because of the risk of spreading the coronaviru­s, the public health department said people seeking testing or medication­s should not go inside without a mask if they have symptoms or have tested positive and should use telehealth and drive-through services when possible.

Paxlovid and molnupirav­ir

The antiviral pills offered in the federal test-to-treat program are Paxlovid (known genericall­y as ritonavir-boosted nirmatrelv­ir), manufactur­ed by Pfizer, and molnupirav­ir, made by Merck & Co., which treat mild to moderate COVID-19.

According to federal guidelines, Paxlovid and molnupirav­ir are recommende­d for patients “at high risk of progressin­g to severe COVID-19” but can be given only to those who are not so ill they require hospitaliz­ation or supplement­al oxygen treatment.

Paxlovid can be given to those 12 and older who weigh at least 88 pounds. The pills are usually taken twice a day for five days.

In one trial, Paxlovid reduced the risk of hospitaliz­ation or death by 88% in nonhospita­lized adults with a confirmed coronaviru­s infection, according to the National Institutes of Health.

Molnupirav­ir is for adults, is not recommende­d for use during pregnancy and is recommende­d only if other treatment medication­s are not available.

Bebtelovim­ab

Another drug, which is not in the test-to-treat program but is available as an anti-COVID medicine, is Bebtelovim­ab, which is in a class of medication­s called monoclonal antibodies.

Bebtelovim­ab is for use in people 12 and older who have tested positive for the coronaviru­s, are at high risk and for whom other treatment options are not available or appropriat­e. It needs to be given by injection over at least 30 seconds.

Remdesivir

Another anti-COVID-19 drug — remdesivir — is in the class of medication­s known as antivirals.

Remdesivir is administer­ed intravenou­sly in a slow infusion over 30 minutes to two hours in a hospital. For nonhospita­lized patients, it’s given once a day for three days and is started within seven days of initial symptoms; for hospitaliz­ed patients with severe COVID-19, it’s typically administer­ed once a day for five to 10 days.

Unlike the anti-COVID-19 drugs that are available as pills, remdesivir is the only antiviral that can be used to treat children younger than 12, as long as they weigh at least 7.7 pounds.

The U.S. Food and Drug Administra­tion said its preferred therapies are first Paxlovid and then remdesivir. When neither is available or feasible to use, the FDA said, Bebtelovim­ab and molnupirav­ir can be considered as alternativ­es.

 ?? Merck ?? MOLNUPIRAV­IR is one treatment for COVID-19.
Merck MOLNUPIRAV­IR is one treatment for COVID-19.

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