Pharmacists Can Now Prescribe Paxlovid, Pfizer's COVID-19 Treatment

State-licensed pharmacists can now prescribe Paxlovid, Pfizer's COVID-19 antiviral treatment, to people who have been recently infected and are at high risk for severe disease. This update comes after the U.S. Food and Drug Administration (FDA) revised its emergency use authorization of the drug on Wednesday.

Previously, only licensed doctors, nurses, and physician assistants were allowed to prescribe the treatment to patients, as stated by the FDA. Experts say the adjustment not only recognizes the important role pharmacists have played and continue to play in the fight against COVID-19, but it allows people to have greater access to timely treatment.

"Pharmacists have been very important partners in COVID and we can now extend safe access and timely access to patients who may not be able to get the drug before." Katherine Yang, PharmD, MPH, clinical professor at the University of California–San Francisco School of Pharmacy, and an infectious diseases clinical pharmacist at UCSF Medical Center, told Health. "It's really about the patients and this is a great thing for them."

Paxlovid is an oral antiviral regimen that consists of 30 pills taken over a five-day period. It's meant to be taken as soon as possible after a diagnosis, and within five days of symptom onset. The medication is authorized for emergency use to treat mild-to-moderate cases of the virus in people who are at high risk for severe COVID-19.

According to Yang, this addition is especially beneficial for patients who live in rural communities that may not have the ability to reach a primary care physician, emergency room, urgent care facility, or Test-to-Treat site along with people who may be traveling, or are out of state and can't reach their primary care doctor.

"Pharmacists are readily available and we have pharmacies in lots of places that we don't have healthcare facilities. Retail pharmacy is one of the most available and accessible healthcare options in the country," Yang added. "I would think of this as just another tool in the toolkit and the more tools we have, the better so people have options."

Who Can Get Paxlovid From a Pharmacist?

According to the FDA, Paxlovid is currently authorized for use for adults and children above 12 years old and who weigh at least 88 pounds.

Jeff Gladd, MD, an integrative medicine physician and chief medical officer at Fullscript, added that Paxlovid is recommended to be focused on high-risk patients—including those who are immunocompromised or over the age of 65—who have an increased chance of hospitalization or death following a COVID-19 diagnosis.

But in order for a state-licensed pharmacist to prescribe Paxlovid, a patient must meet some additional eligibility requirements, the FDA advised. Patients looking to get a Paxlovid prescription from a pharmacist must also be able to provide:

• A list of all medications they are taking, including over-the-counter medications to screen for drugs that can have potentially serious interactions with Paxlovid.
• Electronic or printed health records that are less than 12 months old, including the most recent reports of laboratory blood work. This is so the pharmacist can review for any kidney or liver problems. The FDA states pharmacists can receive this information through a patient's healthcare provider as well.

This is extra information helps pharmacists to determine whether a patient is allowed to receive a prescription for Paxlovid, and how that prescription may need to be altered. "There are dosage adjustments that need to be made for moderate kidney impairment and should be avoided in those with severe kidney or liver impairment, which is why a review of recent blood work is essential before prescribing," said Dr. Gladd.

In the event that a patient is not able to provide a list of all medications and updated health records, or if an already prescribed medication needs a dosage adjustment to make Paxlovid safer to take, pharmacists may refer the patient to a physician, advanced practice registered nurse, or a physician assistant licensed or authorized to prescribe drugs, Jason Gallagher, PharmD, a clinical professor at Temple University's School of Pharmacy and a clinical pharmacy specialist in infectious diseases at Temple University Hospital, told Health.

The FDA said in a press release that while this action allows state-licensed physicians to prescribe Paxlovid with certain limitations, community pharmacies not already participating as a Test-to-Treat site can decide if or how they will offer service to patients.

How to Get a Prescription for Paxlovid

According to the U.S. Department of Health and Human Services (HHS), you can qualify for Paxlovid if you've tested positive for COVID-19 and are at high risk for developing severe disease. You must also have mild-to-moderate COVID-19 symptoms that have lasted for five days or fewer.

Even though pharmacists have been added to the list of healthcare professionals who can prescribe Paxlovid, the FDA noted that patients who test positive for COVID-19 should still consider seeking care or treatment from their regular healthcare provider or a Test-to-Treat location first.

Gallagher agreed and said patients shouldn't only see their pharmacist for a Paxlovid prescription. Instead, pharmacists should be seen as an additional tool in a situation where other options such as a primary care doctor or nurse aren't available.

"Pharmacists should not become the primary gatekeepers of everyone with COVID to receive therapy," Gallagher said. "To me, the point is [to address] some of the gaps that exist in the care network that we currently have, to add one more type of healthcare provider who can help."

If a patient is looking to get a prescription for Paxlovid, experts recommend they contact their primary care provider first to determine if they qualify for treatment. The next best step is for all patients to have access to their healthcare data to work with a pharmacist if access to other care is limited.

"This is a great step towards access and increasing equity," said Yang. The more people we can treat sooner and within the treatment window without having to overtax our existing healthcare system, that's a win."