New York City says it is ready to take on ‘Test to Treat' initiative

Despite modest stockpiles of oral COVID treatments, New York City says it is ready to carry out the new federal initiative to treat patients who test positive on the spot.

The Department of Health and Human Services on Tuesday outlined details for the "Test to Treat'' initiative, introduced by President Joe Biden in his State of the Union address last week. The program allows individuals who receive a positive COVID test result to receive treatment with antiviral pills on the spot. It kicked off Monday, and participating pharmacy-based clinics, federally qualified health centers and long-term-care facilities are eligible to receive direct distributions of molnupiravir and Paxlovid from HHS. Molnupiravir was developed by Merck and Ridgeback Biotherapeutics and Paxlovid comes from Pfizer.

The initiative will tap a separate federal supply that will not affect current state allocations that are going to other sites and providers. Providers that can obtain those treatments outside of Test to Treat were directed to consider treating newly diagnosed patients on the spot.

A federal Test to Treat website to locate participating pharmacies is expected to launch in midmonth. Patients do not have to be tested at a Test to Treat site to receive treatment with the medication.

Pharmacies across the country have reported having trouble accessing Paxlovid. Biden, in his address, said Pfizer is expected to deliver an additional 1 million courses of the pill this month.

New York state is seventh in the nation for accessing these oral treatments, which are ordered through the federal government. As of March 2, New York providers were eligible to order 56,948 courses of molnupiravir and Paxlovid combined across the state, of which over 44,0348 were available on hand, according to HHS data.

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City providers were eligible to order more than 20,088 courses of the two drugs, and they had more than 14,386 available on hand. Of that amount, local facilities could order 13,968 courses of molnupiravir and 12,013 were available in 11 sites. For Paxlovid, city providers could order 6,120 courses and had 2,373 on hand in six sites.

"We have enough supply to meet current demand and we are prepared to get more when needed," said Michael Lanza, a spokesman for the city Department of Health and Mental Hygiene.

When asked about getting the treatments into hands of New Yorkers, Lanza pointed to the free same-day, at-home delivery program for COVID treatments, established in January and conducted in partnership with Alto Pharmacy in Midtown. The company is the exclusive provider of the city's supply of antiviral pills until the supply increases sufficiently to stock multiple pharmacy partners.

Alto's availability of molnupiravir and Paxlovid outstripped other locations by far—as of March 2, it had 11,334 courses of molnupiravir and 2,010 courses of Paxlovid. The next closest facility with stockpiles on that scale was the Sunset Terrace Family Health Center at NYU Langone with just 400 courses of molnupiravir and BronxCare Medical and Dental at Poe with 200 courses of Paxlovid.

"Our city's public healthcare system is seeing a decline in COVID-19 hospital admissions, but we are still very busy treating severely ill patients," said Dr. Mitchell Katz, president and CEO of NYC Health + Hospitals, during the program's launch. "Free at-home delivery of these antiviral pills will keep high-risk New Yorkers out of the hospital so we can immediately free up critical resources."

This story first appeared in our sister publication, Crain's New York Business.