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U.S. to Provide Free Antiviral Pills Following Positive COVID Test

The “Test to Treat” initiative allows people who test positive at a pharmacy to receive free treatments on the spot.

pharmacist in a mask looking through medication

Medically reviewed in March 2022

Updated on March 2, 2022

During his March 1 State of the Union address, President Biden announced that Americans who test positive for COVID at a local pharmacy would be able to receive an antiviral treatment on the spot at no cost. The new initiative, which has been dubbed, “Test to Treat,” reflects a recent shift in the government’s COVID response strategy from “crisis mode” to a “new normal,” which involves learning to coexist with the coronavirus rather than trying to eradicate it.

Biden specifically referred to Pfizer’s oral COVID pill, known as PAXLOVID. Clinical trial data released in November 2021 revealed the drug reduced the risk for severe disease among people at high risk by 89 percent.

Pfizer’s COVID pill was granted emergency use authorization (EUA) by the U.S. Food and Drug Administration (FDA) about a month later. The EUA specified that people ages 12 and older who are at high risk for severe disease are eligible for the drug within five days of developing mild-to-moderate symptoms. It’s unclear if people must have a risk factor for severe COVID to receive a free course of the antiviral treatment under Biden’s plan.

Since its authorization, however, the drug has been in very short supply. Biden says he’s working to fix that.

"We've ordered more pills than anyone in the world. Pfizer is working overtime to get us a million pills this month and more than double that next month,” the President said during his address.

“If you’re immunocompromised or have some other vulnerability, we have treatments and free high-quality masks. We’re leaving no one behind or ignoring anyone’s needs as we move forward, Biden added.

How the antiviral pill works
Pfizer’s COVID pill can help cut people’s risk for hospitalization and death from COVID.

A Pfizer study of 2,246 adults at high risk for severe COVID-19 showed that its antiviral pill reduced the risk for severe disease or death by 89 percent when given within three days of developing symptoms. The risk dropped 88 percent among those who took the drug five days after showing signs of infection. No deaths were reported.

A separate analysis of an ongoing study of adults who are not at high risk for severe disease showed the drug cut the risk for hospitalization and death by 70 percent.

Pfizer notes its antiviral drug resulted in a 10-fold drop in viral load after five days in both the high-risk group and the adults who did not have risk factors for severe disease. Pfizer added that lab data also indicates that its antiviral pill will help protect against Omicron and other known COVID variants.

How does the drug help? The drug contains an ingredient, called nirmatrelvir, which blocks a specific enzyme that the coronavirus needs to replicate.  

U.S. is ramping up its supply
A total of 20 million courses of Pfizer’s COVID pill are slated for delivery to the U.S. government in 2022. Of these doses, about 10 million courses are expected to be delivered by the end of June, and the remaining doses are expected to be delivered by the end of September, according to Pfizer.

“With data showing significant reductions in hospitalizations and deaths, along with the potential for PAXLOVID to maintain robust antiviral activity against Omicron, we believe this therapy will be an important tool in the fight against COVID-19,” said Pfizer chairman and chief executive officer, Albert Bourla in a January 4 news release. “We are pleased to be working with the U.S. government to help broaden patient access to this potentially game changing therapy.”

Article sources open article sources

The White House. “Remarks of President Joe Biden – State of the Union Address As Prepared for Delivery.” Mar 1, 2022.
Pfizer. “Pfizer to Provide U.S. Government with an Additional 10 Million Treatment Courses of its Oral Therapy to Help Combat COVID-19.” Jan 4, 2022.
Pfizer. PFIZER’S NOVEL COVID-19 ORAL ANTIVIRAL TREATMENT CANDIDATE REDUCED RISK OF HOSPITALIZATION OR DEATH BY 89% IN INTERIM ANALYSIS OF PHASE 2/3 EPIC-HR STUDY. Nov 5, 2021.
Merck. “Merck and Ridgeback Announce Submission of Emergency Use Authorization Application to the U.S. FDA for Molnupiravir, an Investigational Oral Antiviral Medicine, for the Treatment of Mild-to-Moderate COVID-19 in At Risk Adults.” Oct 11, 2021.
Merck. “Merck and Ridgeback’s Investigational Oral Antiviral Molnupiravir Reduced the Risk of Hospitalization or Death by Approximately 50 Percent Compared to Placebo for Patients with Mild or Moderate COVID-19 in Positive Interim Analysis of Phase 3 Study.” Oct 1, 2021.

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