Prescriptions for flu medications have declined, but viral respiratory diseases remain a concern

Evernorth data shows a higher prevalence of antiviral medication prescriptions among groups with low flu vaccination rates.
Girl sick

While the holiday season is over, flu season is not. Serious cases of influenza are on the rise, especially among children and youths under 18, Medicaid recipients, and people in the southern United States, according to data from the Evernorth Research Institute. The U.S. Centers for Disease Prevention and Control (CDC) estimates there have been at least 14 million illnesses, 150,000 hospitalizations, and 9,400 deaths from the flu since August 1, 2023.

Evernorth’s analysis of pharmacy claims data for more than 32 million people during the current and past flu seasons found an increasing prevalence of antiviral flu medication prescriptions since Thanksgiving 2023. This indicates that more and more people are experiencing flu symptoms severe enough to warrant a doctor’s visit and a prescription. 

Prevalence of members using antiviral medications for the flu

“Fortunately, fewer people are requiring antiviral medications this year, compared to the previous flu season,” said Urvashi Patel, vice president of the Evernorth Research Institute. “However, the medication trend is still higher than the 2020 to 2021 and 2021 to 2022 flu seasons.” 

Who is impacted most by the flu?

Children and teenagers under the age of 18 tend to have a higher need for antiviral medications, compared with older age groups. Additionally, the CDC has noted a 3.6% drop in flu vaccination coverage among 6- to 17-year-olds compared with the 2022 flu season.

Prevalence of members using antiviral medications for the flu, by age group

Evernorth’s analysis also found that patients covered by Medicaid had a higher use of antiviral medications compared with patients covered by Medicare or commercial health plans. This corresponds with our findings that patients on Medicaid have the lowest rate of flu vaccinations.

Prevalence of flu vaccine for adult members (18+), by insurance type

Evernorth also noted differences among regions. Southern states had the highest prevalence of antiviral medication usage and the lowest rates of flu vaccinations among all adults. “These findings are similar to our observations of the previous flu season, though to a lesser degree,” Patel said.

Prevalence of members using antiviral medications for the flu, by region

Prevalence of flu vaccine for adult members (18+), by region

Dr. Vontrelle Roundtree, MDLIVE associate chief medical officer at Evernorth, said these findings demonstrate the importance of vaccinations to prevent severe flu symptoms – and noted that the need for precautions continues, especially in the wake of holiday gatherings that could have fueled the spread of flu and other respiratory diseases, including  COVID-19 and respiratory syncytial virus (RSV). “While the antiviral medication trends seem to have leveled off somewhat in the last reported weeks, cases of flu and other respiratory diseases are still expected to rise,” she said.

According to the latest data from Evernorth’s MDLIVE, urgent care virtual visits for respiratory issues increased by 36.8% in November over the previous month. In addition, MDLIVE has seen a steady increase in prescriptions for Paxlovid to treat COVID-19 since the start of the flu season.

Paxlovid prescriptions in MDLIVE urgent care sessions

“There is still time to get vaccinated for all of these illnesses,” Dr. Roundtree said. To reduce the risk of illness, she also suggests following the CDC’s recommendations that people wash their hands regularly, stay home from work when feeling sick, and wear masks when appropriate.

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Pharmacy Vaccination Program
The Evernorth Pharmacy Vaccination Program makes sure plan members are covered when they get vaccinated at a pharmacy, an on-site clinic, or other location, and claims are processed through their pharmacy benefit. Enrolled plan sponsors receive a digital vaccination toolkit to help inform and empower members to get their vaccine.