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Pharmacists get FDA approval to directly prescribe COVID pills to patients

a box of Paxlovid
A drug that lessens the symptoms of COVID can be picked up — for free — at pharmacies soon. (rarrarorro / Shutterstock.com)

At-home COVID-19 treatment will be easier to come by thanks to a Wednesday Food and Drug Administration (FDA) decision to give pharmacists the authority to prescribe the antiviral COVID pill directly to patients.

The FDA added pharmacists to the list of healthcare professionals who are allowed to prescribe Paxlovid, Pfizer’s antiviral pill used to mitigate symptoms of COVID-19 — joining doctors, nurses and physician’s assistants among those authorized to prescribe the treatment in the short timeframe when the pill is effective. Here’s what you need to know:

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What is Paxlovid?

Paxlovid is an antiviral treatment made by Pfizer designed to treat COVID-19 symptoms. The FDA issued an emergency use authorization for Paxlovid in December for anyone 12 or older who is experiencing mild to moderate COVID-19 symptoms. Paxlovid is an antiviral therapy that consists of two medications, nirmatrelvir and ritonavir, that are taken in conjunction with each other to block an enzyme in the body which the virus needs to replicate. 

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How effective is Paxlovid?

Pfizer reported the drug was 89 percent effective at reducing COVID-19 hospitalizations in the clinical trial which cleared the way for emergency authorization from the FDA. The treatment needs to start within five days of the COVID-19 diagnosis to be effective according to the FDA — prompting the organization to lessen the hassle for patients searching for Paxlovid as a treatment option.

How much does Paxlovid cost?

Paxlovid is free of charge for patients thanks to the federal government, which is shouldering the bill. Pharmacies could bill insurance for dispensing the medicine according to the state of Michigan but patients should see no out-of-pocket fees themselves. 

How will this impact Michigan?

As of right now, logistics need to be ironed out before Paxlovid is being prescribed by pharmacists in the state. The Michigan Pharmacists Association told Bridge Michigan in an email that they are in contact with the state and are “still learning details” about how this will be implemented. 

Kerry Ott, the public information officer for the LMAS (Luce, Mackinac, Alger, Schoolcraft counties) District Health Department in the Upper Peninsula, told Bridge Michigan the policy could be beneficial in rural parts of the state where access to a primary-care doctor is limited. 

“If pharmacists are allowed by Michigan to prescribe Paxlovid, that would make it easier for us when we hear from someone who tested positive at home,” Ott said. “We can tell them to contact their medical provider or local pharmacy to get therapeutics and that would be a bonus for many in our community who don’t regularly see a physician.”

Will my local pharmacist be able to prescribe Paxlovid?

It depends on the pharmacist. The FDA clearance was for state-licensed pharmacists and it will fall on individual pharmacies on whether or not to offer this service if they are not already a test-and-treat center for COVID-19 according to the FDA press release.

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People who go to their pharmacist seeking Paxlovid will need to have a physical or digital copy of health records that are less than a year old that includes blood work for the pharmacist to review for potential liver or kidney problems and a list of all medications the person is taking or else the pharmacist is legally not allowed to prescribe Paxlovid. As an alternative, pharmacists can consult with the patient’s doctor. 

Is Paxlovid the only COVID pill?

No, but it’s the most effective.

The FDA granted emergency authorization to another antiviral treatment for COVID-19 called molnupiravir made by the pharmaceutical company Merck. However, Molnupiravir is only available to those 18 and up and only recommended by the FDA if no other treatment options are available. Merck reported in its clinical trial that molnupiravir is only 30 percent effective in reducing COVID-19 hospitalizations, compared to 89 percent for Paxlovid.

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