San Francisco-based primary and emergency care provider Carbon Health has partnered with COVID test maker Detect to announce a new service that will allow people to self-test, consult a doctor online or over the phone who may have antiviral pills can prescribe and have the pills delivered — all without leaving home.
The service brings home the approach of the federal government’s statewide “Test to Treat” program — which allows people to visit state facilities to get tested and, if eligible, receive prescription antiviral pills on-site. It marks another evolution in COVID treatment as the virus continues on its way to becoming a more normal, “endemic” part of our lives.
Just a few months ago, the antiviral pill Paxlovid was scarce and was only given to people who were severely immunocompromised. In recent weeks, that has changed as the pills are increasingly available in pharmacies for people with a wider range of less serious conditions. Now, the launch of Paxlovid is beginning to follow a similar path to the earlier launch of COVID test kits: first very difficult to find, then more accessible, and finally available through websites and mail order.
Big players in the healthcare industry make Paxlovid available for delivery, although they generally urge patients to pick up the pills at a pharmacy or send a caregiver to pick them up, as this is often faster and more reliable. Paxlovid treatment must be started within five days of symptom onset and only after a positive COVID test result.
In California, Walgreens offers Medicaid patients free same-day delivery. For patients with other types of insurance plans, Walgreens offers same-day delivery for $10.99. CVS offers same-day delivery in many locations for $7.99, 1-2 day delivery for $4.99, or free delivery for those with CarePass, CVS’s loyalty program that costs $5 per month or $48 per month year costs. Some large healthcare providers also send Paxlovid to patients’ homes. UCSF, for example, can FedEx overnight Paxlovid. Kaiser can deliver to patients’ homes on the same day.
“We will be living with COVID for years to come and need to learn how best to manage it,” said Hugo Barra, CEO of Connecticut-based Detect. “The endgame of the pandemic is to get people treated as soon as possible so they can get back to their lives. So, especially at home, test to treat is the endgame of the pandemic.”
It’s important to get testing and treatment available quickly in people’s homes because many patients don’t live near testing centers or pharmacies that stock Paxlovid. This can increase the time it takes to receive the pills. And people who have tested positive for COVID should try to isolate themselves and avoid going out in public so that home delivery of pills solves the problem of having to pick up a prescription in person.
It comes with a cost: you have to be a Detect user to access it, which means you have to buy the company’s home testing components. These include the $39 machine that processes the tests (a small, reusable tabletop device) and the tests themselves, which cost $49 each. Or you can buy the “starter kit” that includes the machine and a test for $85. The tests are a type of rapid molecular test, similar to PCR, in that they amplify the virus’s genetic material many times over until it is detectable. Molecular tests are more sensitive than today’s home antigen tests and can detect the presence of the virus earlier. Detect ships the test nationwide and offers next-day, same-day, and in some locations within two hours delivery.
If you test positive, you can use the Detect mobile app to connect with a Carbon Health doctor who will conduct a virtual visit – or in person if you prefer – and can prescribe Paxlovid when warranted. Then Carbon works with a pharmacy that can mail you the pills or pick them up the same day.
Carbon operates primary care and emergency care centers in 17 states, including California, and has dozens of Bay Area locations. It was an early leader in coronavirus testing in the region, partnered with the City of San Francisco to operate public testing sites, and later made rapid molecular testing available at many of its centers before some other health care providers did.
You can pay for the Detect device and tests out of your own pocket and claim at least a partial reimbursement from your health insurance company. The federal government requires insurers to reimburse people for up to eight home tests a month at a rate of $12 per test — roughly the retail cost of a home antigen test like the Abbott BinaxNow. The cost of visiting Carbon virtually is covered by most commercial insurers; If you pay out of pocket it’s $69. The Paxlovid itself is free.
Catherine Ho (she/she) is a contributor to the San Francisco Chronicle. Email: [email protected] Twitter: @Cat_Ho
