If you’ve tested positive for COVID-19 and are at high risk of severe illness, you might be wondering about your treatment options, particularly Paxlovid. This oral antiviral medication has become a key tool in preventing serious outcomes from COVID-19. Understanding how to access Paxlovid is crucial for protecting your health. This guide will walk you through everything you need to know about getting Paxlovid, from eligibility and prescriptions to cost and access points.
Who is Eligible for Paxlovid?
Paxlovid is not for everyone who gets COVID-19. It’s specifically intended for individuals who are at higher risk of developing severe illness. The primary goal of Paxlovid is to prevent hospitalization and death in those most vulnerable to serious complications from the virus.
You are likely eligible for Paxlovid if you meet the following criteria:
- Positive COVID-19 Test: You must have a confirmed positive test for COVID-19.
- Mild to Moderate Symptoms: Paxlovid is most effective when started early in the course of the illness, ideally within five days of symptom onset. It’s designed for those with mild to moderate symptoms who are not hospitalized.
- High Risk for Severe Illness: This is a critical factor. Risk factors for severe COVID-19 include:
- Older Age: Being 50 years or older significantly increases risk.
- Underlying Medical Conditions: Chronic conditions like heart disease, lung disease, kidney disease, diabetes, obesity, and a weakened immune system (due to conditions or medications) all elevate your risk. For a comprehensive list, refer to the CDC’s guidelines on People with Certain Medical Conditions and Risk Factors.
- Pregnancy: Pregnant individuals are also considered at higher risk.
If you believe you are at high risk and have COVID-19 symptoms, it’s essential to act quickly. Don’t wait for your symptoms to worsen before seeking treatment.
Getting a Paxlovid Prescription
Paxlovid is only available by prescription from a licensed healthcare provider. You cannot purchase it over the counter. Here’s how to get a prescription:
- Get Tested Immediately: If you experience symptoms of COVID-19, get tested as soon as possible. Rapid antigen tests or PCR tests are both acceptable.
- Contact Your Healthcare Provider: Once you have a positive test result, contact your doctor, physician assistant, nurse practitioner, or other healthcare provider immediately. Time is of the essence, as Paxlovid needs to be started within five days of symptom onset to be most effective.
- Discuss Your Eligibility and Medical History: Your healthcare provider will assess your risk factors, medical history, and current medications to determine if Paxlovid is appropriate for you. Be sure to provide a complete list of all medications you are taking, including over-the-counter drugs and supplements, as Paxlovid can interact with certain drugs.
- Obtain Your Prescription: If Paxlovid is deemed suitable for you, your healthcare provider will write a prescription.
Important Note: Do not delay contacting your healthcare provider even if your symptoms are currently mild. Early treatment is key to Paxlovid’s effectiveness.
Where to Fill Your Paxlovid Prescription
Once you have a Paxlovid prescription, you have several options to fill it:
- Your Regular Pharmacy: Call your usual pharmacy (e.g., CVS, Walgreens, Walmart) to check if they have Paxlovid in stock and can fill your prescription.
- Test-to-Treat Locations: The federal government has established “Test-to-Treat” sites where you can get tested for COVID-19, consult with a healthcare provider, and receive a Paxlovid prescription all in one location. Some sites can even dispense the medication directly. You can find participating locations through the ASPR: Find COVID-19 Medications Locator.
- Pharmacy Clinics: Some pharmacy chains, like CVS MinuteClinic and Walmart pharmacies, offer testing and treatment services, including Paxlovid prescriptions at select locations. Check their websites or call ahead to confirm availability and any associated costs.
- Community Health Centers: If you are uninsured or underinsured, community health centers are a valuable resource. These centers often provide low-cost or free healthcare services, including COVID-19 testing and treatment. You can find a health center near you through the HRSA Health Centers: Find a Health Center or the Minnesota Association of Community Health Centers: Find a Health Center (if you are in Minnesota).
- Health System Clinics: Many hospitals and health systems also offer COVID-19 testing, assessment, and Paxlovid prescriptions. Contact your local health system or clinic for information.
- Public Health Hotlines: If you are unsure where to go or need help understanding your options, public health hotlines can provide guidance and direct you to resources. For example, in Minnesota, the Department of Health Public Hotline can be reached at 1-833-431-2053. The COVID.gov website also offers a helpline at 1-800-232-0233 (English/Spanish) or 888-720-7489 (TTY).
Understanding the Cost of Paxlovid
The cost of Paxlovid can be a concern, but there are programs and resources available to help make it accessible:
- Patient Assistance Programs: Pharmaceutical companies like Pfizer, the maker of Paxlovid, offer patient assistance programs to help eligible individuals access medications at low or no cost. For example, Pfizer’s PAXCESS program provides Paxlovid free of charge to those on Medicare or Medicaid and uninsured individuals through 2024. Those with private insurance can also enroll in PAXCESS for co-pay assistance. You can enroll in PAXCESS through their website: PAXCESS Patient Support Program.
- Insurance Coverage: Many private health insurance plans, as well as Medicare and Medicaid, cover Paxlovid. However, some plans may have co-pays. Check with your insurance provider to understand your coverage details.
- Community Health Centers and HRSA Health Centers: These centers often offer medications at reduced prices or on a sliding scale based on income.
- Medicare Part D: For those with Medicare Part D, it’s important to note that cost-sharing for COVID-19 monoclonal antibody products (though not Paxlovid, which is an antiviral) is not allowed, meaning no co-pays or deductibles for those products under certain circumstances. While this doesn’t directly apply to Paxlovid cost, it highlights the efforts to reduce financial barriers to COVID-19 treatments.
If cost is a barrier, always ask your healthcare provider or pharmacist about patient assistance programs or other ways to reduce your out-of-pocket expenses for Paxlovid.
What to Expect When Taking Paxlovid
Paxlovid is an oral medication taken as a set of pills twice a day for five days. It’s crucial to complete the entire course of treatment as prescribed by your doctor.
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Drug Interactions: Before starting Paxlovid, inform your healthcare provider of all medications, supplements, and over-the-counter drugs you are taking. Paxlovid can interact with certain medications, and your doctor may need to adjust your dosages or recommend alternative treatments. Do not start any new medications while on Paxlovid without consulting your healthcare provider.
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Side Effects: Like all medications, Paxlovid can have side effects. Common side effects are generally mild and may include:
- Dysgeusia (altered or metallic taste)
- Diarrhea
- Muscle aches
- High blood pressure
More serious side effects are rare but possible. Discuss potential side effects and any concerns with your healthcare provider.
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COVID-19 Rebound: Some individuals who take Paxlovid may experience a “rebound” of COVID-19 symptoms a few days after completing treatment. This means symptoms may return, and a repeat positive test is possible. Rebound is generally mild and does not negate the benefits of Paxlovid in preventing severe illness. If you experience rebound, follow CDC guidelines for preventing the spread of respiratory viruses, and inform your healthcare provider. Currently, no additional COVID-19 treatment is recommended for rebound cases.
Paxlovid and Pregnancy & Breastfeeding
- Pregnancy: Pregnant individuals are at high risk from COVID-19, and Paxlovid may be considered an option. While specific safety data in pregnant individuals is limited, current guidelines from organizations like the NIH and ACOG support its use when appropriate. Discuss the risks and benefits with your doctor.
- Breastfeeding: Paxlovid may also be considered for breastfeeding individuals. Discuss treatment options and risks and benefits with your healthcare provider.
Paxlovid vs. Other COVID-19 Treatments
Paxlovid is one of several COVID-19 treatments, but it has become a preferred option due to its oral administration, high effectiveness against severe illness, and broad availability. Other treatments include:
- Molnupiravir (oral antiviral): Another oral antiviral, but generally considered less effective than Paxlovid and has specific recommendations against use in pregnancy.
- Remdesivir (intravenous antiviral): An IV antiviral, which can be used for both outpatient and hospitalized patients. Outpatient Remdesivir requires three consecutive daily infusions, making Paxlovid generally more convenient for most patients.
- Monoclonal Antibodies: While previously used for treatment, most monoclonal antibody treatments are no longer authorized due to their reduced effectiveness against current variants. Pemgarda is one monoclonal antibody authorized for prevention (pre-exposure prophylaxis) in immunocompromised individuals, not for treatment of active infection.
- COVID-19 Convalescent Plasma (CCP): May be used in limited situations for immunocompromised individuals who cannot produce their own antibodies.
Your healthcare provider will determine the most appropriate treatment option based on your individual circumstances, risk factors, and the latest guidelines.
Key Takeaways: How to Access Paxlovid
- Act Fast: If you are high-risk and have COVID-19 symptoms, get tested and contact your doctor immediately.
- Eligibility is Key: Paxlovid is for those at high risk of severe illness.
- Prescription Required: You need a prescription from a healthcare provider to get Paxlovid.
- Multiple Access Points: Pharmacies, test-to-treat sites, community health centers, and health systems are all potential places to get your prescription filled.
- Cost Assistance Available: Patient assistance programs and insurance coverage can help reduce or eliminate out-of-pocket costs.
- Discuss with Your Doctor: Have an open conversation with your healthcare provider about Paxlovid and whether it’s the right treatment for you.
Paxlovid is a valuable tool in the fight against COVID-19, particularly for preventing serious illness in vulnerable individuals. By understanding how to access this medication, you can take proactive steps to protect your health and well-being.