Alex Wills, owner of a pharmacy in south Georgia, was eagerly waiting Monday for his first shipments of a potentially game-changing COVID-19 treatment in pill form.
The two new antiviral pills — both of which require a doctor’s prescription — could be a powerful tool to combat COVID-19 at a crucial time in the pandemic as the omicron variant has spiked the number of new infections. The tablet form of treatment is convenient, can be picked up at a pharmacy and taken at home. All previously authorized drugs for COVID-19 require an IV or injection administered by a medical professional.
Credit: TNS
Credit: TNS
But for now, the excitement of the new treatment options must be measured: the pills will be in extremely limited supply across the state, initially.
Only about 50 pharmacies across the state will receive the first shipments of the two pills. They include only a handful of pharmacies in metro Atlanta with the rest sprinkled throughout the state.
Fulton County, the most populous county in the state, will have no pharmacies that carry the pills. In the metro area, three pharmacies in DeKalb will carry the drugs, along with one each in Clayton and Cobb counties. Douglas and Henry counties also will have one pharmacy each with the pills.
Wills said his pharmacy will be the only one in a 9-county south-central region of the state to receive the first allotments of these pills.
“I expect total madness,” said Wills, owner of Wills Drug store in Ocilla, Ga., of the anticipated demand. “And we’ll see how it goes, but if these drugs do what they say they do, it will be ground-shattering.”
The initial shipments will include 1,620 doses of Paxlovid, manufactured by Pfizer, and 7,500 of molnupiravir, made by Merck. Both drugs recently received an emergency use authorization by the Food and Drug Administration, which means supply could run short until production catches up with the demand.
Credit: Miguel Martinez for The Atlanta Journal-Constitution
Credit: Miguel Martinez for The Atlanta Journal-Constitution
According to guidance issued by the U.S. Department of Health and Human Services (HHS), initial allocations were made to private pharmacies to distribute the pills. DPH said it has partnered with Walmart, Walgreens, and Good Neighbor Pharmacy Group (a group of small independent pharmacies) to ensure the medications are available across the state.
DPH spokeswoman Nancy Nydam said the department’s goal was to get the new treatment to locations throughout the state and to include both urban and rural areas.
She said the department considered several factors in making its allocations, including vaccination coverage and access to other COVID-19 therapeutics such as monoclonal antibodies.
Nydam said DPH anticipates additional allocations in the coming weeks as production increases. She also said they are working to expand the number of pharmacies with access to the pills.
But for now, there’s no way around it. There is simply not enough to go around. This initial shipment totals 9,120 doses of the antiviral pills. The 7-day daily average number of probable and confirmed COVID cases in Georgia is 15,567, according to DPH, and that does not include cases detected by at-home rapid tests not reported to the state.
“When you have such limited supply this is a no-win, tough situation for any state,” said Jen Kates, senior vice president, and director of Global Health & HIV Policy at the Kaiser Family Foundation.
Kates and other public health experts said as states grapple with deciding how to best distribute a treatment in such small quantities, they must take into account not only population sizes but also vaccination rates, access to care and other equity factors.
“When it comes to Fulton County and other parts of the state, fair might mean only considering the population and giving equal access to all communities, said Brian Castrucci, an epidemiologist who had worked for the Georgia Department of Public Health and now heads a public health charity in Maryland. “An equitable approach considers other factors like underlying disease prevalence, mortality, or income. Giving equal access to a rich, healthy neighbor and a lower income neighbor that has been significantly impacted by the pandemic may be fair but it certainly isn’t equitable.”
The COVID-19 pills are not for everyone. Both pills are authorized for patients who are vulnerable to becoming severely ill from COVID-19 because they are older or have pre-existing medical conditions such as obesity or diabetes. Both drugs should be taken as soon as possible after a COVID-19 diagnosis and within five days of first symptoms.
Pfizer’s version appears to be the more effective treatment, with a research trial showing it reduced the risk of hospitalization or death among high-risk patients by about 85%. Merck’s version reduced risk of hospitalization and death in high-risk patients by 30%.
While antivirals may help treat COVID-19, DPH and public health experts emphasized vaccination is the best prevention against COVID-19 infection. Georgians ages 5 and older are eligible for vaccination.
“I find it fascinating that people are clamoring for brand new antivirals that seem to have been developed very quickly, when those same people reject a brand new vaccine that some say was developed too quickly,” said Castrucci. “Americans seem to always prefer a pill over prevention but that is not the way to get through this pandemic.”
Editor’s note: an earlier version of this story had the name of Alex Wills, owner of the pharmacy in south Georgia, incorrect. The name of his pharmacy, Wills Drug, was also misspelled.
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