As hospitalizations and deaths from Covid-19 rise, fueled by a fast-moving new variant that now accounts for a majority of U.S. cases, Paxlovid can help protect patients from some of the worst outcomes of the illness.
But few people end up taking the antiviral medication. Some may not realize they qualify for the drug, or are wary of having a rebound case of Covid.
But there is clear evidence that Paxlovid can prevent severe illness in people at high risk, and it’s still possible to get the drug for free or at a low cost. Here’s what to know.
How does Paxlovid work? And how effective is it?
Paxlovid consists of two medications, which, when taken together, stop the virus from replicating in your body. A recent study from the National Institutes of Health found that taking Paxlovid slashed the risk of death by 73 percent in people at high risk for severe disease.
“Study after study drive home the point that in people who take it, Paxlovid works,” said Dr. Ziyad Al-Aly, the chief of research and development at the Veterans Affairs St. Louis Healthcare System.
Who’s a good candidate for Paxlovid?
Anyone 12 or older who is considered high-risk — which encompasses a broad swath of people. The Centers for Disease Control and Prevention includes conditions such as depression, obesity, asthma or a history of smoking. “To be honest, pretty much if you’re an adult in the U.S., you can meet one of those little marks,” said Dr. Davey Smith, an infectious disease specialist at the University of California, San Diego.
Anyone age 50 or older is also eligible for the treatment, regardless of health status. The older you are, the higher your risk for severe illness tends to be, Dr. Smith said.
Paxlovid may interact with certain medications, including blood thinners and medications that treat cardiovascular disease, raising the risk of blood clots and other complications. Because of this, doctors might recommend that some patients avoid Paxlovid or stop taking a particular medication while on the antiviral.
If you only have mild symptoms, do you really need it?
Paxlovid is intended for people with mild or moderate symptoms.
“Take it as early as possible, to nip it in the bud and prevent yourself from being so sick,” Dr. Al-Aly said.
Even if you currently have few symptoms or you’ve had mild experiences with Covid before, the disease is unpredictable, and you may still want to consider Paxlovid if you’re eligible, Dr. Smith said. “Every time someone gets Covid, it’s basically another game of roulette,” he said.
The virus can cause inflammation throughout the body, Dr. Smith said, raising the risk of blood clots. “You might feel just fine, but you don’t know your body is making a clot,” he said. Paxlovid can reduce the risk of those clots, he said. Some experts think the treatment might also reduce the risk of long Covid, although there is not yet definitive evidence for that, said Dr. Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago. But by reducing Covid symptoms in the first place, the medication may lower the chances that those symptoms linger.
When do you need to take it?
You need to take Paxlovid within five days of developing symptoms. “The earlier you get it, the better it works,” Dr. Al-Aly said.
And finish the full five-day course: “You want to keep taking it long enough to completely eradicate the virus from your body,” Dr. Al-Aly said.
What about Paxlovid rebound?
Whether you take Paxlovid or not, symptoms can roar back in the week or so after recovering from Covid, and you may even test positive again. There isn’t clear data yet on how common rebound is, or whether it happens more often when people take Paxlovid. A December report from the Centers for Disease Control and Prevention found “no consistent association” between antiviral treatment and rebound. And rebound does not appear to increase the risk of hospitalization or death, Dr. Smith said.
“It just means probably a day or two of only your immune system having to step up the game and knock it out,” he said.
How much does Paxlovid cost? Can I get a discount on it?
Until 2024, Paxlovid was widely available for free through the federal government. But now the drug, which has a list price of $1,390, has moved to the commercial market.
That doesn’t mean you will pay that price at the pharmacy counter. Many commercial insurance plans cover the medication, and Pfizer, which makes Paxlovid, offers a program that can bring down or even eliminate the co-pay cost. And Paxlovid is still free for people with Medicare or Medicaid and for people without insurance through a patient assistance program. The N.I.H.-funded Home Test to Treat program also offers free treatments for Covid, including Paxlovid, for adults who test positive.
In a Tuesday meeting, Xavier Becerra, the secretary of the Department of Health and Human Services, reminded pharmaceutical and insurance industry leaders that “no patient should be forced to pay the full out-of-pocket cost to access Paxlovid.”
Source link: https://www.nytimes.com/2024/01/11/well/covid-paxlovid-treatment.html