A new study by health researchers at Verona-based health records company Epic Systems provides further evidence that the latest headline-grabbing COVID treatment can substantially reduce a patient’s chances of hospitalization or death.
Paxlovid, which received emergency authorization from the Food and Drug Administration (FDA) in December, gained new attention last week when President Joe Biden began taking the medication after testing positive for COVID. The FDA recommends the treatment for patients aged 12 and older who have mild to moderate symptoms and at least one factor that puts them at risk for developing severe COVID symptoms. Among those factors are older age; health conditions like kidney disease, cancer and serious heart conditions; pregnancy and obesity.
Under the “Test to Treat” initiative, launched by the Biden administration in March, patients who test positive for COVID through a home or PCR test and have at least one risk factor can contact their health care provider or pharmacy to get a prescription for an oral antiviral medication like Paxlovid.
The program is designed to make the process easy and fast, including for those who don’t have regular contact with a primary care provider. That, in turn, should increase the chance that patients begin treatment within the recommended five-day window after contracting the virus.
The study, published Tuesday by the Epic Health Research Network, used data from Epic’s Cosmos database, which includes records from 149 million patients at hospitals and clinics in all 50 states.
Researchers assessed how often Paxlovid is being prescribed and how well it worked for the patients who took it, which in turn provides evidence about the effectiveness of the federal Test to Treat plan, said Dr. Jacqueline Gerhart, vice president of clinical informatics at Epic Systems.
“We as a nation did a lot of investment in purchasing oral antivirals to try to decrease morbidity and mortality for COVID. And so we, with the Cosmos data set, have real world evidence of what were the outcomes for the patients that did take that treatment,” Gerhart said.
Treatment: ‘Very effective’
The data set included nearly 2 million adult patients who were diagnosed with COVID between December 2021 and early June 2022. The data showed that the frequency with which providers prescribed Paxlovid to patients increased substantially after the Test to Treat program launched in March.
Before then, the rate hovered below 3%. By May 2022, 23% of the patients tracked in the study were prescribed Paxlovid.
Of the COVID patients who did not receive the drug, 9.67% were hospitalized and 1.23% died. Those that received Paxlovid were five times less likely to be hospitalized (1.86%) and 10 times less likely to die (0.12%).
“That was much more of an impact than I had anticipated,” said Brendan Joyce, an Epic Systems software developer who oversaw data analysis for the study. “As someone with parents who are in the 60 to 70 range and have one of these comorbidities, I was really excited to see that this treatment was very effective.”
The study offers valuable insight into treatments for a health crisis that the medical community has had so little time to prepare for.
“It’s been really hard during COVID to find great treatments with validated outcomes that can be accessed by many people,” Gerhart said, adding that the medical community should continue to look for ways to ensure that everyone with risk factors has access to the drug.
“I do see this as one of the opportunities to really fight back during a pandemic that’s been so difficult.”
Digital vaccine cards
In addition to conducting research on outcomes for COVID patients, Epic Systems has rolled out tech tools designed to reduce COVID spread or improve access to treatment. Last summer, the company released its own vaccine passport, a digital alternative to carrying a COVID vaccine card. The tool allows people who have Epic medical records to view their vaccine status within their MyChart accounts.
And in April 2022, after the Biden administration urged electronic health records companies to add tools to help providers prescribe oral antivirals, Epic added a feature to the screens that providers see when they prescribe Paxlovid. The software lets the providers search to see which local pharmacies have Paxlovid in stock, and it warns them if they’re about to send the prescription to a pharmacy that doesn’t have the drug.
Now, the company plans to continue studying Paxlovid, running additional studies to break down their Paxlovid findings by patient age, race and risk factors. Through that research, Gerhart said, “we’ll get a better sense of what’s helping us be successful, and also what are barriers in the future to try to improve the distribution of these applications?” ￼