Dr. B, the online vaccine standby list started by the founder of ZocDoc, is expanding from the realm of COVID-19 prevention into treatment.
Bolstered by $8 million in funding, the company is launching a telehealth platform designed to offer low-cost access to prescriptions. It will start with Pfizer and Merck COVID antiviral pills, the startup announced Tuesday.
Dubbed “visitless prescription,” the service enables patients to access a low-cost online doctor consultation and then send resulting prescriptions to any pharmacy, according to a description on Dr. B’s website. A no-cost option will be available to those who qualify based on income.
As to why Pfizer’s Paxlovid and Merck’s Lagevrio are the first medicines offered as part of the program, more than a million doses have been prescribed since late December 2021 when the Food and Drug Administration issued its emergency use authorizations for the two drugs. Yet communities most at risk of severe COVID-19 outcomes have half the rate of prescriptions compared with less vulnerable communities, according to a Centers for Disease Control and Prevention report.
That’s despite those communities having the most dispensing sites. The Department of Health and Human Services’ Test to Treat initiative, launched on March 7, has helped in that regard. The number of dispensing sites has grown from 49 the first week the drugs became available in December to almost 40,000 by May 21.
More than two-thirds of prescriptions written between December 23 and May 21 were dispensed after the launch of the government program. The program is designed to allow high-risk individuals to be tested, evaluated by a clinician who can prescribe an oral antiviral if indicated, and fill the prescription for free – all at a single site.
But the antiviral pills are most effective within five days of symptom onset and many factors can interfere with timely administration. For one, most pharmacies serving as dispensing sites do not have authorized prescribers available on-site or via telemedicine. Thus people living in high-vulnerability zip codes might face challenges accessing providers who are authorized to prescribe the drugs. The FDA’s July move to allow pharmacists to prescribe Paxlovid may address that issue somewhat, however.
Moreover, the end of a Health Resources and Services Administration program makes paying for teleservices a challenge for the uninsured and may be contributing to the lower antiviral dispensing rates for certain populations, the CDC noted. Also, the number of online services offering the COVID treatments has mushroomed this year. But their reach and benefit has been limited due to hurdles surrounding telehealth access and prescribing issues. Online options sometimes charge significant price markups.
Dr. B, which is “focused on removing as many barriers as possible,” aims to solve the issue of accessing the COVID treatments within the five-day window, said founder Cyrus Massoumi.
Asked how Dr. B intends to reach those who don’t have internet access or who are less familiar with computers, Massoumi said by email, “We see an opportunity to message to younger people who may not be at high risk for COVID-19 themselves, but who may have parents or grandparents who are at higher risk with lower digital literacy.”
He added that offering a no-cost option is “unprecedented for a telehealth startup and is a huge step in terms of expanding access to care.”
Here’s how it works: Patients complete an online health assessment. Once a board-certified physician reviews the patient’s medical record – and, if appropriate, provides the patient with a prescription for a COVID antiviral – she or he can have it filled at a local pharmacy.
The online consultation fee is $15 for most patients – which, Dr. B points out, is less than the average co-pay for a doctor’s visit. The company is also offering no-cost consults for patients who qualify based on financial need. The new service is completely without costs for people who are two-times below the federal poverty level, adjusted for their household size and expenses.
Dr. B raised $8 million from Lerer Hippeau, Founders Fund and other investors to launch the telehealth platform. It has been available in beta in more than 40 states since June, with additional states due to be added soon.
A broader menu of affordable prescriptions is also planned, from heart health to diabetes to reproductive care.