The antiviral drug that treats COVID-19, Paxlovid, must be taken within five days after symptoms begin. To expand quick access to the medication, the U.S. Food and Drug Administration revised the Emergency Use Authorization for Paxlovid in July to authorize state-licensed pharmacists to directly prescribe it.
“We were seeing some really low uptake and even within the pharmacy we were seeing just the medication sit on shelves because prescriptions weren’t coming in,” said Richard Dang, president of the California Pharmacists Association. “There’s a large variety of different reasons for why that might be: Lack of information, but most likely it would be lack of access to a provider who can evaluate the individual and prescribe the medication within that five day time period.”
Now more than a month after the FDA’s new authorization, it is still not easy for many eligible patients to get a Paxlovid prescription directly from their pharmacist.
Before a pharmacist can prescribe a Paxlovid prescription, they need to first conduct a full evaluation where you, the patient, will need to provide:
- Electronic or printed health records less than 12 months old, including the most recent reports of laboratory blood work for the state-licensed pharmacist to review for kidney or liver problems. (State-licensed pharmacists could also receive this information through a consult with the patient’s health care provider)
- A list of all medications you are taking, including over-the-counter medications so the state-licensed pharmacist can screen for drugs with potentially serious interactions with Paxlovid.
“So with all that in mind, it’s not going to be just as easy as walking into a pharmacy and requesting a prescription,” said Dang.
And, some of our most vulnerable community members might have a tougher time meeting these requirements.
“Socially vulnerable populations, such as those that are minority populations who maybe are undocumented or who don’t have regular access to healthcare, unfortunately, are may not have those updated records,” he said.
It’s not just patients facing challenges. Many pharmacies may not be able to prescribe Paxlovid because of COVID-related staffing issues and how much extra time it takes to evaluate patients. Sanjay Patel runs Hallers Pharmacy in Fremont, Calif. His pharmacists will start prescribing Paxlovid, but he says it does take a minimum 20 to 30 minutes to conduct a full evaluation, and that’s best case scenario.
“With all the questions we need to ask, review the documentation, make sure the labs are in order,” he said.
In March, the Investigative Unit first told you about a state survey finding 91% of chain pharmacists and 37% of independent pharmacists reported not having enough staffing to ensure adequate patient care – and this was before pharmacists were allowed to add the extra duty of prescribing the antiviral.
“Not all pharmacists and pharmacies will be offering this service,” said Dang.
The Investigative Unit reached out to CVS, Walgreens and Rite Aid. They all said they do not have any California pharmacists currently prescribing Paxlovid, although they dispense the drug if the patient has a prescription from a medical doctor.
In a statement, the National Association of Chain Drug Stores called the FDA’s new authorization “an extremely important revision” but wants the federal government to “take the necessary next steps to support pharmacy-based assessments” – meaning pharmacy reimbursement for patient evaluations.
To find out whether your pharmacy is prescribing Paxlovid, you should call the location first. You can also find a nearby Test to Treat program, which are government-supported sites set up to test patients for COVID-19 and treat them.
Source: NBC Bay Area