Seasonal influenza might be the last virus on anyone’s mind right now. After two years of COVID-19 (and counting), our collective concern about the seasonal flu seems to pale in comparison. Of course, COVID-19 guidelines, from social distancing to mask-wearing, helped limit the transmission of seasonal flu in 2020 and 2021. But most of those public health restrictions have fallen away. People have returned to offices and schools, where they will be in close contact with others. For those reasons, it’s possible that the seasonal flu will be more severe this year.
The flu vaccine is the best defense against the seasonal virus. Nevertheless, between 2010 and 2020, an average of 28 million people got the flu every year. The seasonal flu can be dangerous for the elderly, the very young, and people with chronic illnesses. For these populations, quick access to flu antivirals like Tamiflu and Xofluza can be the difference between a few days of illness at home and a full-blown hospitalization. Home prescription delivery is a great way to get these medications to patients when they need them: as soon as possible.
There are four antivirals approved in the United States for treatment of the flu. Not all of these are available for home use, however.
- Tamiflu is an oral flu antiviral, available in capsule or liquid form.
- Tamiflu is usually taken for 5 to 10 days, but can be taken for up to 6 weeks.
- It can be used as either a treatment for influenza or as a prophylactic to defend high-risk patients against infection.
- When used to treat the flu, therapy should be started no more than 48 hours after the patient starts having symptoms.
Xofluza (baloxavir marboxil)
- Despite having a different mechanism of action, Xofluza is similar to Tamiflu in that it is an oral medication, available in tablets or an oral suspension.
- It can also be used as a treatment for or as a prophylactic. Xofluza is approved for both uses in patients 5 years old and over.
- Xofluza should also be started within 48 hours of symptoms.
- The difference: patients only need to take one dose for one day, making it ideal for patients who are likely to struggle with adherence.
- Only available as a physician-administered IV infusion, Rapivab is for patients over 6 months of age.
- Like Tamiflu and Xofluza, patients should only be given Rapivab if they have been symptomatic for 48 hours or less.
- Relenza was originally approved in 1999 as a dry-powder inhaler and appears to still be available, but it is not widely used.
- There are clinical trial records of Relenza given as an IV infusion like Rapivab, but that formulation is not currently available.
- It’s unclear whether doctors are actively prescribing Relenza, or whether payors will cover it.
To put it simply, Tamiflu and Xofluza are the two influenza antivirals readily available to patients. But how do patients get their hands on the medication they need?
The 48 Hour Window
Antivirals can reduce the risk of flu complications or death in very old, very young, or chronically-ill patients. But the key to all of these treatments is time. Tamiflu and Xofluza are ineffective if the patient starts therapy more than 48 hours after they start having flu symptoms. But by the time a flu patient seeks out a doctor’s care, they’ve probably been having symptoms for a number of hours, at the very least. By that point, there is a very short window for the provider to write a prescription, the pharmacist to fill it, and the patient to begin taking it.
The Xofluza website attempts to overcome this obstacle by offering a telehealth option through Plush Care. While this is a great start for some patients, Plush Care still directs patients to go to their local pharmacy and pick up their prescription in person. Imagine: a sneezing, coughing, feverish, miserable patient has to put on clothes and shoes. Hopefully they have a car and feel well enough to drive; if not, they’re stuck with public transportation, getting a ride, or walking, none of which are appealing to a sick person. Plus, they’re likely to spread their virus around while they ride the bus or subway. Then they’ll walk into the pharmacy – a place where high-risk patients frequently go – and may spread the virus to people there.
In short, when it comes to antiviral treatments for the seasonal flu, it makes sense to deliver them directly to the patient.
Insurance payors and pharmaceutical manufacturers have the power to reduce viral spread among vulnerable populations by delivering flu treatments within 48 hours. The hard part: making sure patients have access to providers in time to get prescriptions, and having an on-demand delivery option that can get the medication to patients quickly and efficiently.
Telehealth is a good solution for prescribing, but it’s only half of the equation. Sick patients aren’t likely to go to the pharmacy. Even if they do work up the energy to run an errand, they shouldn’t; we all know how far one sneeze can travel. There’s no reason to expose other people to a symptomatic flu patient, especially when it’s so easy to partner with ScriptDrop. Don’t let your patients end up in the hospital with the flu. Get same-day or on-demand delivery and get ahead of the 2022-2023 flu season.