NATIONWIDE COVID-19 TESTING PATTERNS AND DISPARITIES IN POSITIVITY AND ANTIVIRAL TREATMENT IN A U.S. RETAIL PHARMACY CHAIN, SEPTEMBER-DECEMBER 2025
Author(s)
Rachel Brathwaite, PhD1, Laura L. Lupton, MHA, MD1, David G. Fairchild, MD2, Yimin Wu, PhD1, Leena Samuel, MS1, Xiaowu Sun, PhD1;
1CVS Health, Life Sciences Solutions, CVS Healthspire, Wellesley, MA, USA, 2CVS Health, MinuteClinic, Wellesley, MA, USA
1CVS Health, Life Sciences Solutions, CVS Healthspire, Wellesley, MA, USA, 2CVS Health, MinuteClinic, Wellesley, MA, USA
OBJECTIVES: Retail pharmacy clinics are a key access point for COVID-19 testing and treatment in the post-pandemic period. This study characterized the testing population, trends in SARS-CoV-2 positivity and antiviral prescribing, compared symptom burden by positivity, and identified factors associated with positivity and antiviral prescribing within a national retail pharmacy chain.
METHODS: Data from adult patients (≥18 years) receiving COVID-19 testing at ambulatory care clinics within a national retail pharmacy chain from 09/01/2025 - 12/10/2025 were analyzed. Covariates included age, sex, race/ethnicity, U.S. region, Social Vulnerability Index (SVI), insurance type, vaccination status, pregnancy status, symptom count and comorbidity count. Outcomes were SARS-CoV-2 positivity and antiviral prescribing (yes/no). Group differences were assessed using chi-square and t-tests.
RESULTS: Between September and December 2025, 87,601 adults were tested for COVID-19; the population had a mean age of 40.7 years (standard deviation (SD): 16.9), was 65.8% female and 62.7% White, with most residing in the South (65.1%) and in less vulnerable communities (mean SVI: 0.37). Overall, 13.7% tested positive for COVID-19, and 46.7% were prescribed antivirals among those positive. Positivity declined from 22.1% to 8.7% from September to December 2025. Prevalence of key respiratory, systemic, and neurological symptoms was higher among those who tested positive (all p<0.001). SARS-CoV-2 positivity differed by age, sex, race/ethnicity, US region, SVI, insurance type, symptom count, and comorbidity count (all p<0.05). Among patients testing positive, antiviral prescribing remained relatively stable at 46.2% in September to 46.4% in December 2025, and differed by age, race/ethnicity, US region, insurance type, pregnancy status, symptom count and comorbidity count (all p<0.05).
CONCLUSIONS: Retail pharmacy clinics managed high testing volumes nationwide. Positivity declined, while antiviral prescribing was relatively stable (~47%) amongst those positive. Positivity and antiviral prescribing varied by socio-demographic and clinical factors, warranting further investigation into testing and prescribing disparities.
METHODS: Data from adult patients (≥18 years) receiving COVID-19 testing at ambulatory care clinics within a national retail pharmacy chain from 09/01/2025 - 12/10/2025 were analyzed. Covariates included age, sex, race/ethnicity, U.S. region, Social Vulnerability Index (SVI), insurance type, vaccination status, pregnancy status, symptom count and comorbidity count. Outcomes were SARS-CoV-2 positivity and antiviral prescribing (yes/no). Group differences were assessed using chi-square and t-tests.
RESULTS: Between September and December 2025, 87,601 adults were tested for COVID-19; the population had a mean age of 40.7 years (standard deviation (SD): 16.9), was 65.8% female and 62.7% White, with most residing in the South (65.1%) and in less vulnerable communities (mean SVI: 0.37). Overall, 13.7% tested positive for COVID-19, and 46.7% were prescribed antivirals among those positive. Positivity declined from 22.1% to 8.7% from September to December 2025. Prevalence of key respiratory, systemic, and neurological symptoms was higher among those who tested positive (all p<0.001). SARS-CoV-2 positivity differed by age, sex, race/ethnicity, US region, SVI, insurance type, symptom count, and comorbidity count (all p<0.05). Among patients testing positive, antiviral prescribing remained relatively stable at 46.2% in September to 46.4% in December 2025, and differed by age, race/ethnicity, US region, insurance type, pregnancy status, symptom count and comorbidity count (all p<0.05).
CONCLUSIONS: Retail pharmacy clinics managed high testing volumes nationwide. Positivity declined, while antiviral prescribing was relatively stable (~47%) amongst those positive. Positivity and antiviral prescribing varied by socio-demographic and clinical factors, warranting further investigation into testing and prescribing disparities.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH193
Topic
Epidemiology & Public Health
Disease
SDC: Infectious Disease (non-vaccine), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)