TY - JOUR
T1 - Slowed progression
T2 - The utility of Test to Treat initiatives in improving the neglected inequities of COVID-19 among racially/ethnically minoritized groups
AU - Abdul-Mutakabbir, Jacinda C.
AU - Tillman, Frank
AU - Marcelin, Jasmine R.
AU - Saunders, Ila M.
AU - Arya, Vibhuti
N1 - Funding Information:
Provide support and guidance for Medicare and Medicaid reimbursement for pharmacists who prescribe oral antivirals under the Test to Treat program. Although pharmacists have been granted the authority to prescribe the oral antivirals, the lack of reimbursement mechanisms for clinical assessment and counseling of patients is a substantial barrier in their provision of therapeutics, particularly within underserved communities where financial concerns may challenge feasibility.41 Thus, the Centers for Medicare and Medicaid Services should take immediate action to ensure that coverage for pharmacists’ services is authorized under the appropriate insurance coverage mechanisms.41 It is also essential that nondiscrimination clauses be prioritized for pharmacists given that it is imperative for these clinicians to have the ability to order necessary laboratory tests, especially those that assess renal function, which can affect the safety and effectiveness of oral antiviral therapies.28,29 It is worth noting that implementing such a practice would likely require the development of a bidirectional communication tool for pharmacists and other health care providers (physicians, APPs) to rapidly communicate on emergent matters concerning patients treated with the oral antivirals.3 Finally, it is critical that the leadership of community pharmacies provide logistical support and incentive to pharmacists who are tasked with leading Test to Treat sites. Community pharmacists have assumed many roles as integral members of the health care team during the pandemic. This increase in workload, coupled with the exodus of team members from the pharmacy workforce, may be an additional barrier to providing equitable access to oral COVID-19 therapeutics without proper support and planning from pharmacy leaders.It is imperative to maintain a level of urgency around the often-neglected intersections of inequity that continue to exist among minoritized communities amid the pandemic. On an individual level, we must prioritize exploring how social determinants of health affect our patients. On a collective level, we must work to optimize programs designed to promote health equity. The Test to Treat program has the potential to ameliorate the inequities observed across minoritized groups. Intentional public health messaging, the engagement of the appropriate stakeholders, and advocacy for adequate support and appropriate reimbursement for all prescribing parties are of the utmost importance. Furthermore, the federal and state governments must be intentional about specifically identifying marginalized individuals who are socially vulnerable and heavily affected by the pandemic now and in the future given that the short- and long-term sequelae of COVID have the potential to adversely affect these communities the most.47,48 Finally, there must be a continued prioritization of funding and intention in developing low-barrier mechanisms to increase equitable access to and design of Test to Treat programs. It is imperative that we, as a country and as health professionals, continue to place pharmacoequity at the forefront of our efforts to overcome the COVID-19 pandemic. Disclosures: Jacinda C. Abdul-Mutakabbir has served on advisory boards for Shionogi and Entasis Therapeutics and received an honorarium. JRM is a volunteer member of the IDSA Board of Directors. JRM is a member of protocol leadership for the NIH/NIAID/CoVPN vaccine study CoVPN 3006/Prevent COVID U and received salary support for this activity, not related to this manuscript. JRM received consultative honorarium in 2021 for serving on a Pfizer Global Medical Grants/Mayo Clinic Global Bridges Antimicrobial Stewardship Grant review panel, not related to this manuscriptThe authors declare no other relevant conflicts of interest or financial relationships.
Publisher Copyright:
© 2022 American Pharmacists Association®
PY - 2023/1/1
Y1 - 2023/1/1
N2 - In the United States, coronavirus disease 2019 (COVID-19) has resulted in more than 95 million infections and 1 million deaths (as of September 2022), with individuals of racially/ethnically minoritized groups being disproportionately represented among these numbers. Despite the apparent pandemic fatigue in many communities, systemic and structural racism continue to place racially/ethnically minoritized groups at a disadvantage for overcoming the virus, especially as it relates to receiving vaccinations and COVID-19 targeted therapeutics. Test to Treat programs have the potential to mitigate these disparities by rapidly identifying the presence of a COVID-19 infection and readily offering treatment options. Nonetheless, Test to Treat programs must be optimized to adequately address the limitations to care within racially/ethnically minoritized communities.
AB - In the United States, coronavirus disease 2019 (COVID-19) has resulted in more than 95 million infections and 1 million deaths (as of September 2022), with individuals of racially/ethnically minoritized groups being disproportionately represented among these numbers. Despite the apparent pandemic fatigue in many communities, systemic and structural racism continue to place racially/ethnically minoritized groups at a disadvantage for overcoming the virus, especially as it relates to receiving vaccinations and COVID-19 targeted therapeutics. Test to Treat programs have the potential to mitigate these disparities by rapidly identifying the presence of a COVID-19 infection and readily offering treatment options. Nonetheless, Test to Treat programs must be optimized to adequately address the limitations to care within racially/ethnically minoritized communities.
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U2 - 10.1016/j.japh.2022.10.025
DO - 10.1016/j.japh.2022.10.025
M3 - Comment/debate
C2 - 36470731
AN - SCOPUS:85143280893
SN - 1544-3191
VL - 63
SP - 424
EP - 429
JO - Journal of the American Pharmaceutical Association. American Pharmaceutical Association
JF - Journal of the American Pharmaceutical Association. American Pharmaceutical Association
IS - 1
ER -