HHS pushing for equitable access to COVID-19 therapies

Photo: Jeff Lagasse/Healthcare Finance News

This week U.S. Department of Health and Human Services Secretary Xavier Becerra met virtually with pharmacy leaders, pharmacy benefit managers and insurers to discuss HHS' commitment to increase equitable access to COVID-19 therapeutics.

During the call, Becerra said no patient should be forced to pay the full out-of-pocket cost to access Paxlovid, and asked that stakeholders immediately alert HHS of any issues that arise regarding COVID-19 therapeutics access. He reiterated the agency's commitment to ensuring smooth access to oral antivirals for COVID-19 and encouraged all providers to ensure patients who experience issues accessing Paxlovid or Lagevrio are directed to the designated patient assistance programs available for both antivirals.

Becerra also highlighted the importance of continued provider ordering of commercially available oral antivirals, and of provider education.

WHAT'S THE IMPACT?

HHS positioned the call as part of a series of recent actions it has taken to maintain broad access to oral antivirals for COVID-19 as part of the transition to the commercial market.

For instance, since last fall, HHS, the Administration for Strategic Preparedness & Response (ASPR), the Centers for Medicare and Medicaid Services and Pfizer have regularly met with stakeholder groups to discuss increased Paxlovid access and address other stakeholder questions around oral antivirals commercialization.

As of October 13, HHS and Pfizer reached an agreement extending patient access to Paxlovid, beginning Paxlovid's transition to the commercial market. Under the agreement, individuals – including those on Medicare and Medicaid – maintain access to Paxlovid through the end of 2024. The agreement also enables access for the uninsured through 2028, ensures that no HHS-procured product will be lost to expiry, and has ensured that Pfizer will create a stockpile for future emergencies.

On October 27, at the outset of Paxlovid's transition to the commercial market, Secretary Becerra wrote to therapeutics manufacturers, distributors, pharmacies and the payer community requesting their partnership as therapeutics transitioned to the commercial market, and asking that they inform HHS immediately if they encounter any operational problems that impede patient access to these treatments.

Then on January 4, CMS released guidance for Medicare Part D plans that describes coverage and processing claims for COVID-19 therapeutics.

THE LARGER TREND

According to HHS, vaccines are available to protect older adults in the U.S. against all three winter respiratory illnesses – COVID-19, flu and RSV – and there are millions of courses of free USG Paxlovid at provider sites across the country available by the federal government. Free COVID-19 tests are also available at COVIDTest.gov.

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com