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COVID anti-viral pills 'welcome addition' for Iowa pharmacies, but come with challenges

Two antivirals were approved to treat COVID-19 in December, but some worry access to treatment could be limited.

DES MOINES, Iowa — Two new COVID-19 treatments can be lifesaving, but some are sounding the alarm, saying the drugs can be hard to get for patients and expensive for small pharmacies.

Dr. Jeff Brock, a MercyOne infectious disease pharmacy specialist said the two anti-viral pills—Molnupiravir and Paxlovid—are a "welcomed addition" to the COVID treatment options. But, both come with challenges.

Paxlovid, for example, has a long list of possible drug interactions. Molnupiravir, meanwhile, is less that 50% effective. Both also need to be prescribed early. Doctors say both are most effective when patients start taking them within the first five days of having symptoms.

"I think the process of getting them can be convoluted, and it's somewhat difficult because of the speed at which you need to seek the medications," Brock said.

Then there are supply issues.  

While MercyOne said they have plenty of both medications on hand, that's not the case in every pharmacy.

Leslie Herron, the owner of Sumpter Pharmacy in Adel, said it can be costly to independent pharmacies to keep the drugs available.

"We care. We want to provide health care. Why wouldn't I want to participate in the oral antiviral rollout?" Herron said. "What's happened now on the back end, though, is we incur a lot of costs to participate in these programs."

The National Community Pharmacists Association sent a letter to the federal government in mid-January asking for higher reimbursement. The worry is that smaller pharmacies will choose not to carry the drugs.

"We either participate and go out of business, or we stay in business and provide health care that we can," Herron said. "And until that issue's addressed, you're not going to see a lot of access to these medications."

So, what do you need to know?

First, doctors say prevention is best.

"We are still advocating immunization over treatment," Brock said. "The best thing to do is prevent COVID-19 as much as possible."

If you do think you might have COVID-19 and are at high risk, get in to see your doctor early.

"Those patients, if they want treatment, need to seek health care, seek [an] appointment with their healthcare provider as soon as possible because these drugs are most effective when given early in the disease course," Brock said.

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