Washington, D.C.—More than 28,000 community pharmacies are located in federally recognized underserved communities, according to an American Pharmacists Association (APhA) analysis, but only 700 Test-to-Treat sites have been established in those communities to provide oral antivirals to COVID-19 patients.

The APhA points out that better utilizing pharmacies in those areas could increase access to treatments by about 3,900%.

When granting emergency use authorization of oral antivirals for COVID-19, such as Paxlovid, the FDA included a limitation that prevents pharmacists from ordering the medications.

The group recently released an analysis showing that underserved and vulnerable communities in the United States do not now have equitable access to care. As of early May, when the analysis was conducted, slightly more than 2,300 Test-to-Treat sites were in existence and only 22% were in the most vulnerable areas in the country as defined by the Social Vulnerability Index. Additionally, only 30% of Test-to-Treat sites are in medically underserved areas of the U.S.

"Although HHS [Department of Health and Human Services] has recognized the high level of training pharmacists receive by authorizing pharmacists to prescribe COVID-19 therapeutics, FDA's emergency use authorizations for oral COVID-19 antivirals specifically exclude pharmacists as prescribers," the APhA stated in a press release. "As a result, the majority of pharmacies cannot serve as Test-to-Treat sites. These medications are being underutilized and sitting on pharmacy shelves, which unnecessarily increases health care costs and puts lives at risk."

The APhA said it was calling on the federal government to include the nation's more than 70,000 community pharmacies as prescribers of oral COVID-19 antivirals. It said that would significantly increase equitable access to Test-to-Treat pharmacies "by opening the door to communities that need it the most."

The association pointed out that nearly 90% of the U.S. population lives within 5 miles of a pharmacy.

For the analysis, COVID-19 Test-to-Treat location addresses (as of May 6, 2022) were determined using public domain data from HealthData.gov. Pharmacy location addresses (as of July 13, 2021) were determined using public domain data from the Centers for Medicare and Medicaid's National Plan and Provider Enumeration System National Provider Identifier (also known as NPPES NPI) registry.

Information on medically underserved areas, medically underserved populations, and health-professional shortage areas were gathered through public data provided by the Health Resources Services Administration.

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