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ACP Signs Onto Amicus Briefs Supporting New York State Guidelines Considering Race in Prioritizing COVID-19 Antiviral Treatment

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Lawsuits filed against the guidelines argue that use of racial preferences in distribution of COVID-19 treatments is unconstitutional

March 18, 2022 (ACP) -- The American College of Physicians is joining with other medical organizations to oppose federal lawsuits that seek to overturn New York state guidelines that prioritize high-risk people -- including minorities -- for use of the new COVID-19 antiviral medications nirmatrelvir (Paxlovid) and molnupiravir.

ACP supports the guidelines because it believes it is appropriate to consider risk factors when determining how to distribute limited treatments. ACP is especially cognizant of research that suggests systemic racism accounts for many of the disparities in the impact of COVID-19 on American racial and ethnic groups.

“Our policy calls on physicians to not only take responsibility for the health and welfare of individual patients under their care, but to also consider the well-being of the community as a whole at a systems level, including in institutional policies and other guidelines,” said Renee Butkus, ACP director of health policy. “Risk stratification is common in medicine, and it is important for physicians to be able to utilize their own clinical judgement in making decisions about treatment.”

According to a press statement from New York City, the two antiviral drugs are authorized to “treat patients with mild-to-moderate COVID-19 who are at high risk for progression to severe disease, regardless of vaccination status.”

A law professor filed the lawsuit against the state and New York City Health Department, arguing that “New York's use of racial preferences in the distribution of COVID-19 treatments is unconstitutional.” The New York State Health Department cites “longstanding systemic health and social inequities” that have contributed to an increased risk for severe illness and death for non-whites.

ACP filed a “friend-of-the-court” brief -- a document designed to provide legal guidance to judges -- in conjunction with several other groups, including the American Medical Association and the American Public Health Association.

ACP and its allies argue that it is appropriate to consider a patient's race or ethnicity in making decisions about the risk for severe progression “because social inequities and racism exacerbate COVID-19 morbidity and mortality in minoritized populations.”

The coalition also filed a similar brief in a related case challenging the state guidelines on behalf of a group of New York state residents. However, earlier this week that case was dismissed.

ACP has laid out a framework that confronts the various, interconnected and compounding aspects of U.S. society that contribute to poorer health outcomes for persons based on their race, ethnicity, religious and/or cultural identities in the policy paper titled “A Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care.”

ACP also discussed these topics in its policy paper “Addressing Social Determinants to Improve Patient Care and Promote Health Equity.”

What is next as the legal system considers the lawsuits? “While this lawsuit is based in New York, there are other states that are working to implement similar policies and that are facing similar issues with doing so,” Butkus said. ACP will continue to monitor the legal landscape with an eye toward opportunities to speak on behalf of physicians and patients.

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Back to the March 18, 2022 issue of ACP Advocate