Previously, only physicians, nurse practitioners, and physician’s assistants were permitted to prescribe Paxlovid. Allowing pharmacists to prescribe any drug is very rare in the United States. Some states allow pharmacists to prescribe a narrow list of medications—and often only under a provider’s supervision.
Under the revised authorization, the FDA will allow state-licensed pharmacists to prescribe Paxlovid on their own to eligible patients. However, there are a few caveats.
Pharmacists must consult with a patient’s physician or review their health records to make sure the patient is not taking any medications, supplements, or over-the-counter (OTC) products that could interact with Paxlovid. The pharmacist must also be able to confirm a patient’s liver and kidneys are functioning before prescribing the drug.
“For Paxlovid to be effective, it is essential to start this medication as soon as possible, and looking to pharmacists to help get the drug to the patients that can benefit most makes good sense at every level,” Preeti Malani, MD, MS, MSJ, professor of medicine in the Division of Infectious Diseases and former chief health officer at the University of Michigan, told Verywell.
Public health experts hope that allowing pharmacists to prescribe Paxlovid will increase its use, especially among people who do not have primary care providers.
According to the Centers for Disease Control and Prevention (CDC), older adults and people with certain chronic conditions (including diabetes, obesity, and heart disease), are at high risk for severe COVID.
While the cost of the drug is free (the government is paying for it) people may still have to pay for an appointment to get the prescription.
“This could have a modest effect toward increasing Paxlovid use,” Marcus Plescia, MD, MPH, chief medical officer of the Association of State and Territorial Health Officers, told Verywell. “Every little bit helps when it comes to getting this drug out there to people who can benefit from it.”
A Contentious Decision
After the FDA’s decision to allow pharmacists to prescribe Paxlovid, some medical organizations emphasized the importance of seeking a prescription from a primary care provider or physician.
While noting that the move has the potential to expand access to timely treatment, the Infectious Diseases Society of America (IDSA) issued a statement recommending that people get prescriptions from primary care physicians whenever possible, deeming these providers the “most knowledgeable about a patient’s medical history and potential interactions.”
A statement from the American Medical Association (AMA) was more adamant about physician-ordered prescriptions:
“While the majority of COVID-19-positive patients will benefit from Paxlovid, it is not for everyone, and prescribing it requires knowledge of a patient’s medical history, as well as clinical monitoring for side effects and follow-up care to determine whether a patient is improving—requirements far beyond a pharmacist’s scope and training.”
However, the infectious disease specialists that Verywell reached out to expressed full support for the FDA’s decision to allow pharmacists to prescribe Paxlovid.
“As a COVID physician who works closely with pharmacists and relies heavily on their expertise, I fully support expanding privileges of pharmacists to prescribe Paxlovid,” Priya Nori, MD, an associate professor of medicine at the Albert Einstein College of Medicine and medical director of the Antimicrobial Stewardship at the Montefiore Health System, told Verywell. “No providers understand drug interactions like they do. Their comfort level may be higher than that of the average primary care, ER, or urgent care provider, groups who in my experience, remain hesitant to prescribe this drug.”
Malani agreed, noting safety is top of mind for pharmacists.
“The biggest clinical concern with Paxlovid is drug-drug interactions, and pharmacists are uniquely positioned to help make decisions about whether or not Paxlovid can safely be given to a particular patient by carefully reviewing their concurrent medications,” said Malani.
How to Get Paxlovid
Paxlovid must be taken within five days of symptoms starting. Therefore, it’s important for patients to know how to access the drug in a timely fashion. Pharmacists now have the authority to prescribe Paxlovid, but that does not mean that all pharmacies will immediately have the ability or resources to fill a prescription. Setting up the program may take time.
A representative from CVS told Verywell the pharmacy chain does not plan to expand Paxlovid prescribing capabilities to pharmacists outside of its Minute Clinic locations. Walgreens says it is likely to start the program in underserved communities.
Here are a few ways to get Paxlovid if you’re eligible:
Call your provider. If you test positive for COVID and have a primary care provider who knows your recent medical history, start by asking them if you can get Paxlovid. If your provider thinks the drug is right for you, they can call a prescription into your local pharmacy and you can pick it up. Most providers don’t charge for phone visits. If the pharmacy has a drive-through window for pickup, go with that option or ask about same-day delivery so you can avoid being around others while you’re sick. Visit an urgent care clinic. If you test positive for COVID at home or have symptoms and want to be tested and evaluated, check your local urgent care centers. They have health providers that can examine you and write a prescription if needed. You’ll still need to go to a pharmacy to pick up your prescription if the provider authorizes Paxlovid. If your insurance does not cover the cost of the urgent care visit, expect to pay $100 to $150 to see a provider. Find a Test to Treat center. In March, the Biden Administration launched “test to treat” centers to help get Paxlovid to eligible people as quickly as possible. You can use this locator to find a center near you, which could be a pharmacy, community health center, or other location. If you’ve taken a COVID home test, bring it with you; otherwise, you can take a free test at the center. The center might be able to dispense Paxlovid if they determine it’s right for you, or let you know the closest pharmacy that can. There is no charge for any of these services. Visit a pharmacy clinic. Some pharmacies have store-based clinics with authorized staff who can test, evaluate, prescribe, and dispense Paxlovid. However, if the clinic is not affiliated with the Test to Treat program, you could be charged for the evaluation. If your insurance does not cover it, the fees can range from $50 to $150. Use an app. As of November 2022, consumers can use the CVS website or app to see if they are eligible for Paxlovid. If you qualify, you can either arrange to pick it up at your nearest location or have it delivered to you same-day for $7. 99. Walgreens is using apps like DoorDash and UberEats to deliver Paxlovid to people who have been prescribed the drug but can’t go to a local pharmacy to pick it up. If you live within 15 miles of a participating location, the delivery is free. Make a telehealth appointment. An efficient way to get Paxlovid is through a telehealth visit. A provider can send an immediate prescription to a local pharmacy for you to pick up or have delivered. Michael Mina, MD, PhD, a former associate professor of epidemiology, immunology, and infectious diseases at the Harvard T. H. Chan School of Public Health, told Verywell it’ll help if you have rapid tests on hand before your telehealth visit. Mina’s testing company, eMed, offers online visits for Paxlovid evaluations. You must use the test provided by eMed (which can be delivered to you overnight), and a staff member must proctor your test by video. The test, proctoring, and evaluation costs $25.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
