The Texas Medical Association is keeping tabs on the Biden administration’s new “One-Stop Test to Treat” plan for COVID-19, which will feature distribution of two oral antiviral medications to hundreds of facilities nationwide for “on the spot” prescribing if a person tests positive.
The Biden administration on March 8 released details of the plan, which increases rapid availability of the antivirals but raised concern in organized medicine about how the new plan will affect the relationship between patients and their primary care physicians.
“Through this program, people who test positive for COVID-19 will be able to visit hundreds of local pharmacy-based clinics and federally qualified community health centers (FQHCs), and residents of long-term care facilities will in one stop, be assessed by a qualified health care provider who can prescribe antiviral pills on the spot,” the U.S. Department of Health and Human Services (HHS) said in a statement. “This ensures that, if people who are at high risk for developing severe disease test positive and if administration of an antiviral is appropriate, they can get treatment quickly and easily.”
An accompanying HHS fact sheet explained the agency “already distributes COVID-19 treatments, including oral antivirals, to states and territories for free on a weekly basis. All qualified heath care providers can prescribe these therapeutics to patients who are at increased risk for developing severe COVID-19.”
The new initiative involves sending the antiviral pills molnupiravir and Paxlovid to the participating pharmacy-based clinics, which was scheduled to begin on March 7. And HHS is launching a program for long-term care pharmacies to directly order antivirals to increase access to the drugs for their residents, the fact sheet explained.
“These pharmacy-based clinics and long-term care facilities join hundreds of FQHCs in our hardest-hit and highest-risk communities – these centers will provide access for people to get tested, receive a prescription from a health care provider if appropriate, and have their prescription filled, all at one convenient location,” the fact sheet said.
After President Biden made an undetailed mention of the initiative in the State of the Union address – but before the HHS statement and fact sheet provided more clarity – the American Medical Association expressed concern with the pharmacy-based clinic part of the plan. AMA said that pharmacy-based clinics “typically treat simple illnesses such as strep throat,” and leaving “prescribing decisions this complex in the hands of people without knowledge of a patient’s medical history is dangerous in practice and precedent.”
“We urge patients who test positive for COVID-19 to contact their physician to discuss treatment options,” AMA President Gerald Harmon said in the statement. “COVID-19 is not strep throat – it is a complicated disease that has killed nearly 1 million people in the United States.”
TMA Associate Vice President of Public Affairs Michelle Romero said TMA would monitor implementation of the federal plan and balance the need for quick testing and treatment with the need to preserve the primary care physician’s role.
“We’re going to keep tabs on it. COVID is still a big public health concern,” she said. “[Federal officials] want people to get tested in a timely manner and of course get treated. But we don’t want this undermining the relationship [patients] have with their primary care physician and the medical home.”
HHS noted the initiative does not allow pharmacists themselves to prescribe Paxlovid or molnupiravir. “The Test to Treat initiative does not change existing requirements for a qualified health care provider to write the prescription,” the fact sheet said.
Besides patients who visit the participating facilities for a test, people who test positive for COVID at home will be able to use a Test to Treat location to receive a prescription and treatment at that facility “if eligible,” HHS said.
A federal Test to Treat website to find participating sites is anticipated to launch in the middle of this month.