Free COVID Antiviral Pills: Who Is Eligible and Where to Get Them

To check the spread of COVID-19, Americans will have free access to antiviral pills as soon as they test positive at a pharmacy, President Joe Biden announced at his first State of the Union address on Tuesday night.

“We are also ready with antiviral treatments,” Biden said, referencing Pfizer’s Paxlovid, which has been shown to reduce the chances of hospitalization or death due to COVID-19 by nearly 90% and received emergency use authorization from the Food and Drug Administration in December.

As part of the White House’s “Test to Treat” initiative, Pfizer is expected to deliver a million pills to US pharmacies by the end of March and “more than double that” in April, Biden added.

“We’re leaving no one behind or ignoring anyone’s needs as we move forward,” he said.

Here’s what we know about COVID antiviral medications, how to access them and when the Test to Treat program will begin.

Who can get a free course of COVID antiviral pills?

The White House hasn’t announced full details for the Test to Treat program, but Biden indicated in his address that anyone testing positive for COVID-19 at a pharmacy would immediately be eligible for a course of oral antiviral pills.

White House Coronavirus Response Coordinator Jeff Zients said Wednesday testing and treatment would be available to individuals for free “all in one stop.”

Previously, some health care providers were unsure about fulfilling prescriptions for the antivirals, and supplies were extremely limited.

“The demand is just outstripping the supply for these oral antivirals right now due to the quickly spreading omicron variant,” Dr. Elise Choi, an internist in Somerville, Massachusetts, told the AMA in early February. “Most of the access for these medications are being directed by the state health departments to specific local health departments, pharmacies, clinics, hospitals and physician offices.”

Choi added that not all doctors could get antivirals on-demand for their patients. “There’s a lot of state-to-state variability.”

Which pills will be made available?

In his address, Biden indicated Pfizer’s Paxlovid has been authorized as part of the Test to Treat program. 

The oral medication has proven 89% effective in preventing hospitalization and death from COVID-19 if administered within three days of symptoms, according to the pharmaceutical giant. If given within five days, it still reduced the risk of severe reaction by 88%.

Merck’s antiviral, molnupiravir, also received emergency authorization by the FDA in November. The White House already purchased 1.7 million courses of the drug in anticipation of that approval, but Biden did not mention it in his remarks.

Molnupiravir, developed by Merck and Ridgeback Biotherapeutics, has ultimately proven much less effective than Paxlovid. (It was only narrowly approved by the FDA’s advisory committee by 13 to 10.) 

In clinical trials, it only decreased the risk of hospitalization from COVID-19 by 30%, down from 50% in early results. 

“That’s not all that good. It’s pretty lackluster,” Katherine Seley-Radtke, a University of Maryland medicinal chemist, told Nature.

How does the antiviral pill work?

Several vaccines have proven effective at preventing COVID-19 and lessening the severity of disease for so-called breakthrough cases. But for those already infected, antiviral drugs are needed to actively treat the condition.

Paxlovid is actually a combination of two medications: the antiviral ritonavir, which is paired with the newer drug, nirmatrelvir.

Nirmatrelvir is designed to block the activity of the SARS-CoV-2-3CL protease, an enzyme that the coronavirus needs to replicate. The ritonavir allows the medication to remain active in the body longer and at higher concentrations.

The two work together, disrupting the replication of COVID-19 virus in infected patients. Pfizer says the pill has proven effective against more serious delta and the omicron variants of COVID-19.

The Paxlovid protocol requires taking two tablets of nirmatrelvir and one tablet of ritonavir, twice per day for five days within five days of symptoms appearing. 

During clinical trials, reported side effects were similar to those of a placebo, according to the pharmaceutical company.

Which pharmacies are participating?

Further details are expected to be announced in the coming days, but CVS, Walgreens and Kroger are among the “hundreds of sites” that will offer the treatment, a White House official told Axios.

Paxlovid will also be distributed directly to clinics, community health centers, long-term care facilities and veteran health centers, Ziets said Wednesday. 

GoodRX has a tracker showing where Paxlovid and molnupiravir are available.

When does the Test to Treat program start?

The White House worked with Pfizer to speed up delivery of the pills, making hundreds of thousands of them available much earlier than expected. It’s expected Paxlovid will be available to customers who test positive for COVID-19 later in March, though more specifics will be forthcoming.

If it follows the precedent of the distribution of free N95 masks, some locations will have access to Paxlovid before others. 

It’s not clear yet if proof of insurance will be requested. A Walgreens spokesperson said the company “will provide additional details regarding rollout in our stores as it becomes available.”

A representative for CVS told CNET the company’s MinuteClinic — where clinicians can screen, diagnose and treat customers — as well as the chain’s large number of branches, make it “uniquely positioned to help support the government’s Test to Treat initiative and look forward to helping provide expanded access as additional inventory becomes available.”

Will widespread use of antivirals lead to drug-resistant COVID-19?

The overuse of some antibiotics has led to drug-resistant strains of diseases like tuberculosis and gonorrhea. But that’s unlikely to happen with Paxlovid because the course of treatment is so short — just five days. “It won’t put selective pressure on the virus to evolve,” Monica Gandhi, an infectious disease expert at the University of California, San Francisco, told CNET earlier.

Will making the pills available cause vaccination rates to decline? 

“During this pandemic, we’ve done everything in our power to get people to take the vaccine — we’ve incentivized, cajoled, mandated,” Gandhi said. “At this point, a year since the first vaccine was announced, I don’t think we’re going to change someone’s mind.”

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.