State of the Union: COVID-19 test-to-treat initiative, opioid epidemic, Moonshot program

During his State of the Union address, President Joe Biden announced the launch of a new test-to-treat initiative, in which people who test positive for SARS-CoV-2 at a pharmacy can receive antivirals “on the spot at no cost.”

The initiative is part of the administration’s newly unveiled National COVID-19 Preparedness Plan. In addition to pharmacies, the “one-stop” test-to-treat locations will include community health centers, long-term care facilities and U.S. Department of Veterans Affairs facilities across the U.S. The sites will be operational sometime this month, according to the White House.

In December, the FDA authorized two oral antivirals — Paxlovid (Pfizer) and molnupiravir (Merck) — for the treatment of COVID-19 in patients who are at high risk for severe disease. According to the agency, the treatments should be taken as soon as possible after a COVID-19 diagnosis, and within 5 days of symptom onset.

“If you get COVID-19, the Pfizer pill reduces your chances of ending up in the hospital by 90%,” Biden said. “Pfizer is working overtime to get us 1 million pills this month and more than double that next month.”

Biden also mentioned that “scientists are working hard” to make COVID-19 vaccines available to children aged younger than 5 years, and that more at-home COVID-19 tests will be available for free.

“Even if you already ordered free tests tonight, I am announcing that you can order more from COVIDTests.gov starting next week,” he said.

Most people who attended the State of the Union address were maskless, including Biden.

“With 75% of adult Americans fully vaccinated and hospitalizations down by 77%, most Americans can remove their masks, return to work, stay in the classroom and move forward safely,” he said.

The U.S. will continue sending COVID-19 vaccine doses to other countries. An estimated 475 million doses have already been sent to 112 countries, “more than any other nation,” Biden said.

The COVID-19 pandemic was one of several health care issues that Biden addressed.

Prescription drug costs

Biden also spoke about the need to lower prescription drug costs, including insulin. While it costs manufacturers about $10 to make one vial of insulin, patients with diabetes are charged up to 30 times that price, Biden said.

“Let’s cap the cost of insulin at $35 a month so everyone can afford it,” he said. “Drug companies will still do very well. And while we’re at it, let Medicare negotiate lower prices for prescription drugs like the VA already does.”

Nursing homes

Medicare is going to raise the standards for nursing homes, Biden said. On Monday, the administration announced a set of reforms to ensure that nursing homes are adequately staffed and trained to provide high-quality care. Facilities that do not meet these standards will be cut off from taxpayer dollars, according to a White House press release.

During the pandemic, more than 200,000 nursing home residents died from COVID-19, representing nearly one-quarter of all COVID-19-related deaths in the U.S., the release said. An investigation conducted by the Government Accountability Office found that 82% of all inspected nursing homes lacked infection prevention and control measures from 2013 to 2017.

To address this, Biden called on Congress to provide nearly $500 million to CMS, a 25% increase, to bolster health and safety inspections in nursing homes.

Unity agenda

Biden also proposed a “unity agenda for the nation” to tackle four other issues: the opioid epidemic, mental health, support for veterans and cancer.

To combat the opioid epidemic, Biden urged Congress to increase funding for prevention, treatment, harm reduction and recovery services. He also called for the removal of “outdated rules” that prevent physicians from prescribing opioid use disorder treatment.

Last year, HHS lifted the 8-hour training requirement that health care providers needed to obtain a waiver to prescribe buprenorphine. Clinicians who are interested in obtaining the waiver must submit a notice of their intent with the Substance Abuse and Mental Health Administration, and those who utilize the waiver are limited to treating no more than 30 patients for opioid use disorder at any one time, according to HHS. The agency also said the waiver only applies to Schedule III, IV and V drugs or combinations of these drugs. It does not apply to Schedule II medications such as methadone for the treatment of opioid use disorder.

Biden also called for better access to mental health services and “full parity between physical and mental health care,” more benefits and comprehensive health care for veterans “devastated by toxic exposures in Iraq and Afghanistan,” and funding to meet his goal for the Cancer Moonshot program, which aims to cut cancer deaths by at least 50% over the next 25 years.

“To get there, I call on Congress to fund ARPA-H, the Advanced Research Projects Agency for Health. It’s based on DARPA — the Defense Department project that led to the internet, GPS, and so much more,” Biden said. “ARPA-H will have a singular purpose — to drive breakthroughs in cancer, Alzheimer’s, diabetes and more. We can do this.”

References:

• Biden announces initiative to pair coronavirus tests with treatment. https://www.nytimes.com/2022/03/01/us/politics/biden-will-cite-tremendous-progress-against-an-unpredictable-virus.html. Accessed March 2, 2022.
• Fact sheet: Protecting seniors and people with disabilities by improving safety and quality of care in the nation’s nursing homes. https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/. Accessed March 2, 2022.
• National COVID-19 Preparedness Plan. https://www.scribd.com/document/562156436/National-COVID-19-Preparedness-Plan#download. Accessed March 2, 2022.
• Remarks of President Joe Biden – State of the Union address as prepared for delivery. https://www.whitehouse.gov/briefing-room/speeches-remarks/2022/03/01/remarks-of-president-joe-biden-state-of-the-union-address-as-delivered/. Accessed March 2, 2022.