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The crucial role antivirals – and pharmacists – play
Health care providers have a new weapon in the fight against COVID-19, and it’s coming to a pharmacy near you.
More than 1.04 million people in the United States have died since the advent of COVID-19. But although new infections, hospitalizations, and deaths have declined since their peak, more than 100,000 new cases still are reported every day – likely significantly less than the actual number. Fortunately, treatment for COVID-19 infection is now readily available in this country.
|89% reduction in the risk of hospitalization and death
Paxlovid is the first at-home oral antiviral medication authorized for treating COVID-19. It helps keep high-risk patients ages 12 and older from getting so sick that they need to be hospitalized.*
Manufactured by Pfizer and distributed under an Emergency Use Authorization from the US Food and Drug Administration (FDA) , Paxlovid is the brand name for two separate medications that are packaged together: nirmatrelvir and ritonavir. Here’s how they work in a three-pill dose:
The history of antivirals
Antivirals are prescription medications that help the body fight off viruses that cause disease. They also can ease symptoms and shorten the length of an infection. They are commonly used to prevent or treat hepatitis, herpes, HIV, and seasonal flu.
Antivirals come in pill, liquid, inhaled powder, topical, and intravenous solution forms. Remdesivir, the first approved treatment for COVID-19, is administered intravenously.
Paxlovid is an investigational SARS-COV-2 protease inhibitor. Protease inhibitors are a class of medications that interfere with the ability of certain enzymes to break down proteins and thus inhibit the virus’s ability to replicate.
The first antiviral drug was approved in 1963.
Pfizer began working on protease inhibitors in 2003, during the SARS outbreak. Although the project had been shelved in the interim, it positioned the company well for the rapid development of a treatment for COVID-19 – nirmatrelvir.
Although there have been some COVID-19 “rebound” cases reported after the administration of Paxlovid, experts still believe it is the strongest defense against hospitalization and death for high-risk patients.
Expanding the role of pharmacists
The FDA’s Emergency Use Authorization permits state-licensed pharmacists to prescribe Paxlovid.
Pharmacists are among the most trusted professionals in the United States, and they’re also nearby: Ninety percent of Americans live within five miles of a pharmacy, and most make an average of 35 pharmacy visits a year.
Not all patients are eligible for a Paxlovid prescription. Under the FDA’s emergency use authorization, patients with an increased risk of developing severe COVID-19 side effects are eligible for Paxlovid if they:
- tested positive for COVID-19
- have not yet been admitted to the hospital
- are at high risk for developing severe COVID-19 symptoms
- are 12 years of age or older
- weigh at least 88 pounds
At CVS Pharmacy, patients can check their eligibility for Paxlovid through our convenient digital screener and, if eligible, schedule an appointment with a pharmacist; verify details, and authorize payment; or receive a referral for care if not eligible for a prescription from a pharmacist.
In order to prescribe Paxlovid, a pharmacist must have access to the member’s medical records, including a list of medications he or she is already taking, and blood test results to assess for kidney or liver impairment from the last 12 months. Our pharmacists are equipped with access to electronic health records (EHRs), an important and foundational step to supporting the evolution of health care at pharmacy.
Like our pharmacists’ ability to access electronic health records, the digital screener is a key part of our program to ensure a positive member experience and facilitate pharmacists’ ability to provide patient care for eligible patients. Ultimately, these and other programs serve our goal of increasing access to affordable care and positioning pharmacists as integrated providers within the patient health care team.
Pharmacists evolve to provide holistic health care
In recent years, pharmacists’ scope of practice has expanded to include essential care and services such as administering immunizations, providing disease education and medication management services, offering nicotine cessation support, and in some states (where permissible), prescribing hormonal contraceptives.
We believe pharmacists would be even better equipped for their role as holistic health care providers if we continue to expand the types of clinical care services that pharmacy teams can provide in local communities, from expanded women’s health care services to chronic disease and lifestyle management; and if these privileges are separated from special emergency rules and made permanent.
* A product called Lagevrio (molnupriavir) is manufactured by Merck and is also available, but studies suggest it reduces associated risks by only 30 percent. Lagevrio is not approved for prescribing by pharmacists.
This article contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Health.