CVS pharmacists now can assess COVID-19 patients and prescribe Paxlovid for quick treatment

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CVS Pharmacy said Friday its pharmacists are now clinically assessing patients who are COVID-19 positive and prescribing antiviral pills for those eligible.

According to a news release Friday, pharmacists are prescribing Paxlovid at more than 9,000 CVS drugstores across the country. There is no cost for the pills but a $60 assessment fee is charged to patients, which can come out of Health Savings Account or Flexible Savings Account funds, CVS said.

The pharmacy chain said the option for getting an over-the-phone assessment should improve access to Paxlovid for COVID-19 patients, as California health officials track an increasing number of omicron variant infections. The antiviral medication is designed to shorten or reduce the severity of COVID-19 illness and must be taken within five days of the first symptoms.

In July, the FDA authorized pharmacists to evaluate people with COVID-19 and prescribe Paxlovid to eligible patients. CVS said it’s jumping ahead with the use of pharmacists to prescribe Paxlovid after spending months reviewing the FDA guidelines, implementing systems and meeting requirements for training.

Walgreens also announced a new service this week for increasing access to COVID-19 treatment — a deal with DoorDash and Uber to deliver Paxlovid to homes. Walgreens said people must have a prescription for the drug from their health care provider.

The FDA’s original authorization in December 2021, allowing the use of Pfizer’s Paxlovid for treatment of COVID-19, only permitted doctors and nurse practitioners to write the prescriptions.

CVS representatives said Medicare and state Medicaid programs do not cover patient services provided by drugstores, so pharmacists can’t bill for prescribing Paxlovid. The $60 assessment fee charged upfront by CVS is similar to a co-payment for a physician’s office visit, the company said.

Nicole Henry, a district leader for CVS Health, said Paxlovid is for people 12 years or older who are at risk of a moderate to severe case of COVID-19.

She said people testing positive for COVID can go to CVS.com or a CVS app to schedule an appointment for a phone consultation with a pharmacist. People are expected to answer screening questions online, and the pharmacist must look at the patient’s blood tests in the past year before approving the prescription.

Henry said in most cases the pharmacist can call up patients’ electronic records to review kidney and liver values. A CVS news release said people should be able to get a same-day appointment and get the antiviral pills within a few hours.

“The benefit of Paxlovid is you can treat COVID-19 early,” Henry said. “Patients can get over their symptoms faster and it is also a great opportunity for pharmacists to showcase their ability to prescribe.”

Paxlovid may have significant interactions with drugs that patients are taking for high cholesterol, blood pressure, migraines or other health problems. Prescribers usually consider the risks of the drug interaction or might advise a patient to cut back on taking a statin drug during the five-day course of Paxlovid.

There are reports of “rebound” in some patients, who achieved results from taking Paxlovid but their coronavirus symptoms returned two to eight days later. Studies have suggested it happens in 5% to 14% of cases.

An article in the journal Health Affairs in September said barriers — such as the need to review blood tests — could prevent people from getting access to the antiviral treatment at pharmacies. The authors cited a study finding that a third of patients who see a regular doctor have not had blood work done in the past 12 months.

CVS representatives said vaccinated people who are not sick with COVID-19 can schedule an appointment for a booster shot guarding against the omicron variants. A shot guarding against the seasonal flu can be administered at the same time.

“One of the worst things we can see is a patient getting the flu and COVID-19 at the same time,” Henry said. “It does happen.”