N.B. now accepts rapid tests for COVID-19 medication prescription to improve access

New Brunswick is now accepting a positive COVID-19 rapid test result for a prescription for the free antiviral treatment Paxlovid to help increase access, says the province's acting deputy chief medical officer of health.

Until now, a positive PCR (polymerase chain reaction) lab test result has been required unless people work in a nursing home during an outbreak or live in an Indigenous community.

Paxlovid is designed to reduce the risk of hospitalization or death for vulnerable adults with mild to moderate symptoms if taken within five days of the onset of symptoms.

"We did know that in certain regions the ability to get a PCR test and get those results within that five-day window was challenging for some," said Dr. Yves Léger.

The province's COVID-19 treatments website still indicates a PCR test is required, as of Wednesday afternoon, but Léger said the "fairly recent" change was shared last week with doctors and nurse practitioners, who prescribe Paxlovid.

Some pharmacists called for the change last month, saying the drug was still too difficult to access in the province, despite recently expanded eligibility, all primary care givers being given the authority to prescribe it, and it being available at all pharmacies.

New Brunswick was the only Atlantic province that did not accept rapid tests.

A total of 1,074 New Brunswickers have been prescribed the drug to date, said Department of Health spokesperson Michelled Guenard. That's up from 606 in late April and 323 in early April.

The province has 6,226 treatment courses in stock, she said.

By comparison, on P.E.I., more than 1,200 treatment courses have been prescribed, as of April 25.

Paxlovid was approved for use in Canada in January.

Asked about the small percentage of treatment courses prescribed so far, Léger said "a significant number of individuals, when they were approached and asked if they wanted to get treatment, refused it.

"They didn't want to get treatment, either because they felt their symptoms were not severe or they were already starting to get better."

Monitoring impact of changes, supply

In addition, when the province first received the drug, "it was under very tight supply.

"Because of that, we needed to put in place a mechanism to roll that out fairly equitably across the province.

"We did that initially through … a centralized process, so primary care providers could not prescribe it themselves at that time." A team comprised of pharmacists and specialist consultants determined who qualified.

As the supply increased, the province moved to "more community-based access," enabling primary care providers to prescribe it.

The number of prescriptions has increased since then, which points to improved access, the said.

Although some provinces, such as Quebec and Alberta, have extended prescribing privileges to pharmacists to further increase access, Léger said New Brunswick has no immediate plans to follow suit, but didn't rule it out.

The province wants to wait and monitor the impacts of the other changes first, he said.

"What we certainly don't want to do is open it up too quickly and then, you know, we quickly deplete our stocks."

"But we'll certainly be looking at that, you know, depending on if our supply numbers continue to be good."

Right now, "there's no issue around supply that would restrict access at all," he added.

The province has no information on when its next shipment of Paxlovid will arrive, the Department of Health spokesperson said.

No statistics on outcomes

Guenard did not respond to a request for any information or statistics on the people who have been prescribed the drug so far, or the success of their treatment.

"The best defence against Omicron is vaccination and we urge everyone to ensure they get their booster dose as soon as possible," she said in an emailed statement.

"Paxlovid has some significant drug interactions with commonly prescribed drugs, and is not for everyone."

People who are eligible for Paxlovid in New Brunswick include those:

• 18 years of age or older and moderately to severely immunocompromised

• 80 years of age and older

• 50 to 79 years of age and not fully vaccinated

• 50 to 79 years of age and living in a long-term care setting or receiving home-care services

• 50 to 79 years of age and from or living in First Nations communities

A full course of treatment requires a patient to take 30 pills — two nirmatrelvir and one ritonavir taken together twice a day for five days.

In November, Pfizer reported that Paxlovid reduced the risk of hospitalization or death by 89 per cent compared to a placebo in non-hospitalized high-risk adults with COVID-19.

To get a prescription for Paxlovid, people who have tested positive for COVID should contact their primary care provider. People who don't have a primary care provider, or timely access to their provider, should call TeleCare 811 or visit evisit NB for an online consultation with a nurse practitioner or doctor.