Live Updates: Tracking Fills for Cold, Flu, and COVID Treatments

The GoodRx Research Team is tracking prescription fills for medications that treat seasonal viral respiratory infections. Our live tracker includes fills for:

• Tamiflu (oseltamivir) for influenza

• Paxlovid and molnupiravir for COVID-19

• Antibiotics such as amoxicillin for bacterial infections associated with respiratory syncytial virus (RSV)

We'll update the charts below weekly and include fill trends from past seasons to help shed light on any potential changes in treatment this season.

Click on each tab to view prescription fill trends for each condition.

Why track treatment fills?

Fall and winter are the height of flu and cold season. During these months, the viruses that cause common respiratory infections, such influenza, coronavirus, and RSV, spread widely. In many cases, these infections don't cause serious illness. But they can be deadly for children, older adults, and those with weakened immune systems.

The CDC actively monitors these viruses through tools such as the FluView for influenza, the COVID19 Data Tracker, and the Respiratory Syncytial Virus Surveillance system. These tools help Americans understand the risk of contracting these viruses. But they don't tell us how people are treating these infections.

To this end, the GoodRx Research Team has developed several tracking tools to monitor prescription fills for medications that treat these respiratory infections.

By tracking fills of these medications, we hope to provide insight into:

• Whether Americans are taking (or not taking) FDA-approved treatments for the flu, COVID-19, or bacterial infections associated with RSV

• Whether healthcare professionals are prescribing these medications at rates in line with CDC-reported infection rates

• How treatment patterns for the current cold and flu seasons compare to prior seasons

These tools can be used along with the CDC's viral surveillance data and provide insight into national treatment trends.

Making sense of Tamiflu (oseltamivir) fills for flu treatment

Tamiflu (oseltamivir) is one of the key antiviral medications recommended by the CDC to treat influenza. It can also be used to prevent the flu if someone has had close contact with another person who tested positive for the flu. Tamiflu is usually prescribed for 5 days to help reduce the severity of symptoms and increase recovery time.

The GoodRx Research treatment tracker uses the CDC's weekly influenza reporting system to monitor national weekly fill rates for influenza antiviral medications. We began reporting data at the start of the flu season, which is the 40th week of the year and usually falls in the first week of October. The flu season typically peaks between December (week 48) and February (week 7). The weekly numbering system restarts the first week of January.

What can we expect?

Based on previous years, we expect Tamiflu fills to increase between December and May. There's usually a peak in fills around February and March. For example, in the 2023-2024 season, Tamiflu fill rates significantly increased in mid-December and peaked in February. Unlike past years, that season lasted into May, suggesting a longer flu season.

An early uptick between October (week 40) and December (week 48), relative to prior years, may suggest an early influenza season. This happened in the 2022-2023 flu season. High prescription fills between April (week 12) and June (week 22) may suggest a late, sustained flu season. And high Tamiflu fills between June (week 22) and September (week 37) may suggest an unusual off season. This could be due to lower flu vaccination rates earlier in the year or new influenza variants not accounted for in the flu vaccine design.

Making sense of Paxlovid (nirmatrelvir/ritonavir) and Lagevrio (molnupiravir) fills for COVID-19 treatment

Paxlovid (nirmatrelvir and ritonavir) and molnupiravir are oral antiviral medications. They are used to treat people with mild-to-moderate COVID-19 infections or who are at high risk of developing severe infections. You should start taking these medications within 5 days of first having symptoms.

GoodRx Research is tracking the national fill rate over a 52- to 53-week period, starting at week 40 for Paxlovid and molnupiravir.

What can we expect?

Unlike the common cold and the flu, we're still learning about COVID-19 seasonal patterns. And COVID-19 medications are fairly new. Rochelle Walensky, the former director of the Centers for Disease Control and Prevention, has stated that COVID-19 may become a seasonal virus. And there are reports that COVID-19 rates will spike as kids return to school in the late summer and early fall.

This suggests COVID-19 rates may increase during the late fall and winter months and again in late summer/early fall. If that's the case, we should see an increase in Paxlovid and molnupiravir fills during this time. That appeared to happen in the 2022-2023 and 2023-2024 seasons. Fills for Paxlovid increased in the winter, tapered off in the early spring, and went up again during the late summer as school resumed.

The 2021-2022 seasonal pattern was a bit different from these seasons. COVID-19 medications were first approved during this season, and their use surged as they entered the market between April (week 16) and September (week 36).

Making sense of fills for antibiotics that treat RSV

Respiratory syncytial virus (RSV) is a contagious respiratory virus that commonly infects and spreads in children. But it can also affect adults. Currently, there's only one FDA-approved vaccine to protect infants from RSV, Abrysvo, which is given to pregnant women.

The FDA has also approved two other RSV medications: Beyfortus (nirsevimab-alip), to help prevent RSV infections in children up to 24 months of age, and Synagis (palivizumab), which is prescribed to children at high risk for severe lung disease caused by RSV.

RSV causes cold symptoms. In most cases, it will run its course without medical treatment within 7 to 10 days with adequate rest and hydration.

Healthcare professionals may prescribe amoxicillin or other antibiotics if:

• A secondary bacterial infection related to RSV needs to be treated.

• They cannot tell whether the infection is RSV, the flu, or another bacterial infection. So they may prescribe antibiotics out of caution.

We are tracking oral solution antibiotics rather than the FDA-approved treatment for RSV for two reasons:

• Oral solution antibiotics are a common treatment for severe RSV complications in children, and the fill trends should match up with RSV surveillance data of infections.

• Prescriptions for RSV-specific FDA medications are newer and have limited data.

What can we expect?

RSV has a seasonal pattern. It peaks during the winter months, so we can expect an increase in antibiotics filled for respiratory infections around then.

The chart below shows that antibiotic prescription fills mirror the CDC's RSV surveillance data - particularly for oral solution amoxicillin. Fills spiked between December and February, during the peak of RSV cases, and faded by late spring.

How to reduce the risk of contracting a respiratory infection

Some of these medications do not stop viral shedding. That means people who are infected and taking them can still spread the virus. That's why it's important to protect yourself from infection. Here are some measures you can take:

• Get the flu and COVID-19 vaccines. Both are effective at reducing the length and severity of infection. You can get discounted or even free flu vaccines at some pharmacies.

• Wash your hands often. This can keep virus-carrying droplets at bay.

• Avoid touching your eyes, nose, and mouth.

• Visit your healthcare professional if you feel sick. You can compare telehealth options in your state using GoodRx - and even see someone online through GoodRx Care. The sooner you visit, the sooner you can get the prescription you need.

• Stay home if you're feeling sick or having symptoms, and isolate for the recommended time period based on your respiratory infection.

The CDC guidelines recommend self-isolation for at least 24 hours since your last fever and improvement of symptoms. For RSV, the CDC does not state isolation guidelines. But people infected with RSV are usually contagious a few days before they have symptoms and can be contagious for 3 to 8 days. Some state public health departments encourage parents and caregivers to keep children at home when the child has acute respiratory illnesses.

For more information, contact [email protected].

Co-contributors: Jeroen van Meijgaard, PhD

Methodology

Weekly prescription fill rate reporting convention: Prescription fill rate is based on a statistically significant sample of fills at U.S. pharmacies. Data comes from several sources, including pharmacies and insurers, and provides a representative sample of nationwide U.S. prescription medication volume. The fill rate represents the percent total fill for only oral solution amoxicillin over the total number of all fills in the same period. We presented data using the CDC's weekly influenza reporting system convention, which starts on the 40th week of the year (October) and runs up to the fall of the following year (week 39). We used the average of week 52 and week 1 to add a 53rd week to flu seasons that spanned nonleap years.

Prescription medication used in study: We used the following influenza antiviral medications in this study: Tamiflu (oseltamivir), Xofluza, Relenza, Rapivab. For COVID-19, we used the following medications: Paxlovid, molnupiravir, and Lagevrio. For antibiotics, our data only includes oral solution antibiotics indicated for upper respiratory infections and sinus infections, and primarily used in children.

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