More COVID treatment pills are being prescribed in wealthier Virginia ZIP codes and the state wants to know why – The Virginian-Pilot

ByDonald L. Leech

Jul 18, 2022

More than four times as many prescriptions for COVID-19 treatment pills were filled with wealthier Virginia ZIP codes than those with the lowest state incomes last month.

The Virginia Department of Health is trying to figure out why.

In Virginia’s wealthiest and least-struggling ZIP codes, 14,740 prescriptions were filled, while in middle-income and struggling ZIP codes, 5,974 prescriptions for oral COVID-19 treatments were filled. In the lowest-income and most-struggling ZIP codes, 3,296 prescriptions for the treatments were filled in the previous month, according to VDH data.

“This is something that we’ve been following very closely since the launch of antivirals,” said Alexis Page, one of the therapeutic healthcare coordination leads for the health department’s COVID-19 task force. .

There are several issues with the data that make it difficult to tell whether the disparity exists because of the actual need for treatments or access issues, she said.

The VDH tries to determine how much of a particular area is even eligible for oral treatments, Page said. To be prescribed oral treatments such as Paxlovid, a person must have tested positive for COVID-19, be at high risk for more severe symptoms, and experience mild to moderate symptoms for five days or less without being hospitalized, according to the department. American. health and social services.

Since July 8, pharmacists have been able to prescribe Paxlovid. Since then, VDH estimates, there is a higher proportion of people in wealthier ZIP codes who test positive for COVID-19 who need antivirals, around four in five, according to the data provided. Estimates for the same period for the middle income and vulnerable are 58% and the most vulnerable are 56% of people who test positive for COVID-19 need a prescription for oral antiviral treatment.

However, Page pointed out that these numbers are estimates based on limited data.

One complication is the lack of knowledge about how many people have tested positive for COVID-19 at any given time, as many home test results are not reported to VDH, according to Page. Another is that the prescription data filled does not take population density into account, and many of Virginia’s low-income ZIP codes tend to be rural with smaller populations.

“We’re doing our best with the numbers we have and to remove that statistical noise as best we can,” Page said.

Nearly a third of Virginia’s 1,216 COVID-19 oral antiviral providers — 464 — are in ZIP codes with the lowest ranks for income, health, language and transportation. The trend mirrors the situation nationwide – where the rate of oral treatments was lowest in the most vulnerable ZIP codes, even though they had the highest number of sites to receive the drug, according to a June report. from the Centers for Disease Control and Prevention.

The disparity is appearing across the state, said Dr. Cynthia Romero, director of the M. Foscue Brock Institute for Community and Global Health at Eastern Virginia Medical School. She said it can be difficult to find a solution when the data can’t point to one clearly.

“It’s a big problem if you don’t have the real data to draw the right conclusions,” Romero said.

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People might understandably have hesitation and reservations about engaging with the health system because of negative experiences, she said.

But raising awareness through trusted community groups, such as churches, can help the health department disseminate important information such as the availability of COVID-19 treatment and how to obtain that treatment, Romero said.

VDH is setting up free test-to-treat centers where people can get prescriptions for antivirals if they test positive and are eligible for treatment, as well as keeping providers informed about the availability and effective use of oral antivirals , according to the health department.

Romero said community groups and health groups need to provide good information to communities that the health department alone may not be able to reach.

“It really takes everyone’s cooperation,” Romero said. “VDH cannot do it by itself.”

Page said the department wanted to make sure the drugs were distributed equitably and that patients across the state could access the treatment.

“I think we’re going to have to do our best with the numbers we have,” Page said.