Paxlovid – information for health professionals
Last updated on October 18, 2024
On this page: Reduced patient need for Paxlovid | Prescribing guidance |Dispensing information | Resources | CanTreatCOVID and BC Cancer
Pfizer anticipates there may be a temporary shortage of Paxlovid due to increased demand. Resupplies are expected:
- November 1 – renal dose packs
- November 25 – renal dose and regular dose packs
Pfizer has guidelines for health professionals on how to adjust regular dose packs for patients with renal impairment.
To prevent further shortages, pharmacies are asked not to stockpile medication. Ordering restrictions may apply. Check this page for more information as it becomes available.
Nirmatrelvir/ritonavir (Paxlovid™) is an oral antiviral treatment indicated to reduce the risk of hospitalization in adults with mild to moderate COVID-19 at high risk of progressing to severe COVID-19. It is indicated for adults who are moderate-to-severely immunocompromised, and/or 60 years or older with a high-risk chronic condition.
Treatment is for a total of 5 days. If a patient remains symptomatic after 5 days of treatment, another course of Paxlovid is not indicated.
Paxlovid is covered under Plan Z at no cost for B.C. residents with active MSP coverage.
Prescribers are encouraged to use the eForm for prescribing
Reduced patient need for Paxlovid
Paxlovid is unnecessary for most people living in B.C. The drug is only beneficial to groups that are considered at higher risk of progressing to serious illness, such as patients who are severely immunosuppressed. Since Paxlovid became available in January of 2022., B.C. residents have developed even stronger immunity to COVID-19 through previous infections and widespread vaccinations.
Treatment decisions should also consider safety risks, as Paxlovid is known to interact with many medications and is associated with adverse effects. Refer to COVID-19 Care Treatments for more information.
Prescribing guidance
BC PharmaCare has developed prescribing guidance for Paxlovid, which can be found on the eForm. The criteria indicates Paxlovid for:
- Moderate-to-severely immunocompromised individuals
- People aged 60 years and older with at least one high-risk health condition
For more information on prescribing, including dosing recommendations for renal patients, refer to BC CTC guidelines
Dispensing information
| DIN | Generic name | Brand name | Dosage form | Maximum PharmaCare covers |
|---|---|---|---|---|
| 02524031 | nirmatrelvir/ritonavir | Paxlovid | 150 mg nirmatrelvir / 100 mg ritonavir tablets (30 tablets) | $1391.99/package |
| 02527804 | nirmatrelvir/ritonavir | Paxlovid | 150 mg nirmatrelvir / 100 mg ritonavir tablets (20 tablets) | $1391.99/package |
Drug-drug interactions
Paxlovid has many drug-drug interactions. Please refer to BCCDC’s Practice Tool # 3, Lexicomp and University of Liverpool’s interaction checker for more information.
Claims procedures
In PharmaNet, enter:
- Drug cost: cost per package
- Dispensing fee: $10 maximum
- Quantity: 1 package
The Full Payment Policy applies to Paxlovid. Providers may not charge patients any costs associated with the dispense of Paxlovid.
Temporary clinical fees (PAX-A, PAX-F) were provided to pharmacists to dispense Paxlovid during the COVID-19 pandemic. The last fee concluded on December 31, 2023.
Plan Z coverage
Plan Z coverage of Paxlovid is available only for B.C. residents with active Medical Services Plan (MSP) coverage. Exceptional Plan Z coverage is no longer available.
PharmaCare continually reviews its coverage policies for the products it covers. Any change to coverage for Paxlovid will be communicated in advance.
Resources
- Paxlovid prescribing eForm
- Assurance (Plan Z) — Section 7.13, PharmaCare Policy Manual
- BCCDC COVID-19 Care and Treatments
Additional resources - CanTreatCOVID and BC Cancer
CanTreatCOVID
CanTreatCOVID trial of treatments for COVID in community settings: https://cantreatcovid.org/about/
BC Cancer
BC Cancer pharmacists are available between 8am - 4pm Monday through Friday to answer questions and provide information about how Paxlovid should be used in patients undergoing treatment for cancer. Emails sent on weekends and statutory holidays will be responded to by a pharmacist the following working day. Refer to the table to contact the correct centre:
| Centre | Pharmacist consult line |
|---|---|
| Abbotsford | Email: bcca_acacupharmacists@bccancer.bc.ca Phone: 604-851-4710 ext. 645242 |
| Kelowna | Email: BCCA_CSIPharmacists@phsa.ca Phone: 250-712-3900 ext. 686758 |
| Prince George | Email: cndan@bccancer.bc.ca Phone: 250-645-7317 |
| Surrey | Email: BCCA_FVCCPharmacists@phsa.ca Phone: 604-930-4002 #2 |
| Vancouver | Email: ACUPharmacist@phsa.ca Phone: 604- 877-6098 ext. 672632 |
| Victoria | Email: VICACUPharm@bccancer.bc.ca Phone: 250-519-5500 ext. 693795 |