Researchers from the University of Rochester and Harvard University conducted an analysis of data reported to Medicare by nursing homes under special pandemic regulations. The study showed that only around 25 percent of residents with covid-19 were prescribed any antiviral medication between May 2021 and December 2022. The study, which was supported by funding from the National Institutes of Health and the National Institute on Aging, has been published online by JAMA.
The study highlights that nursing homes could have done a better job of administering these treatments to patients, especially considering the availability of Paxlovid starting in the second quarter of 2022. Earlier treatments using monoclonal antibodies required more complex administration methods, contributing to the lower prescription rates. Another antiviral tablet called Lagevrio from Merck is authorized for covid-19 treatment but is not as effective as Paxlovid.
According to Michael Barnett, a clinician and professor of health management and policy at the Harvard School of Public Health, the underuse of Paxlovid in nursing homes likely led to avoidable mortality. Paxlovid was authorized by the FDA in December 2021 and has been shown to reduce the risk of death and hospitalization by significant percentages for high-risk individuals.
However, the study also raises the issue of clinician unfamiliarity with antiviral treatments and patient concerns about the potential for a coronavirus “rebound” after initial treatment. The nursing home industry trade association acknowledged difficulties in accessing medications and obtaining prescribing guidance for physicians. Clear prioritization and guidance from public health officials are essential in protecting vulnerable populations during a pandemic.
The FDA-approved Paxlovid for individuals at high risk of severe covid-19 symptoms, such as the elderly and those with underlying conditions. Although there are some downsides to the treatment, including side effects and potential drug interactions, the researchers emphasize the importance of considering Paxlovid as a means to reduce hospitalization and mortality for nursing home
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