Updates as of October 3, 2023:
Lagevrio (molnupiravir) and Paxlovid (nirmatrelvir/ritonavir) are oral antiviral drugs that are highly effective for preventing hospitalization and death in patients with mild to moderate COVID-19 infection who are at risk for severe disease. Multiple factors are involved to ensure timely administration of oral antivirals, including adequate drug supply and distribution, acceptance of the therapy by health care providers and the public, and patient access to testing, prescriptions, and drug dispensing sites.
The California Department of Public Health (CDPH) has been made aware of occasions where pharmacists have turned away patient prescriptions for COVID-19 oral antiviral therapy due to misinformation or a lack of information. This document provides recommendations to clarify what information is necessary to dispense these therapeutics. It is intended to aid pharmacies serving as dispensing sites for these critical medications. For more information on COVID-19 therapeutics and California's efforts to increase accessibility, please see the COVID-19 Treatment Resources for Healthcare Providers.
In all situations, clinical concerns about inappropriate prescriptions or inappropriate dosing should be weighed against the clinical consequences of delaying or denying treatment that prevents severe illness from COVID-19, which has caused more than 100,000 deaths in California as of September 29, 2023. There is also early and increasing evidence that COVD-19 treatment reduces the risk of developing long COVID symptoms.
As we are likely to continue to see periodic surges of COVID-19 cases, it is important to remain up-to-date on the latest clinical guidance to ensure patients receive appropriate and timely access to highly effective COVID-19 treatment. Pharmacies and pharmacists should be aware they may see a rise in prescriptions for COVID-19 medications for a number of reasons including:
While treatments are an important tool in the fight against COVID-19, vaccines are also a critical component of mitigating the
spread and impact of COVID-19. All individuals are recommended to stay
up to date with COVID-19 vaccinations,
which increase protection against severe COVID-19. Learn more about vaccines at the CDPH Vaccines Site.
The following information is intended to clarify topics that pharmacies and pharmacy staff may need to prevent delayed access to critical COVID-19 treatment:
The number of free test kits varies by health planin network benefits. Uninsured patients can get information on testing at the: CDC No-Cost COVID-19 Testing Locator.
CDPH has learned of several pharmacies that are notifying patients that they are out of stock of COVID-19 oral antivirals and have not replenished their supply. This puts the public at risk for not receiving treatment quickly.
Pharmacists may prescribe COVID-19 therapeutics with certain conditions. Note: Paxlovid is now FDA approved in adults but remains under EUA for ages 12 years old to 17 years old.
These items are not required to be written on the prescription and patients can self-attest to the symptom onset dates.
This information should be shared with stores and facilities staff to ensure correct information and the best possible patient experience are provided.
The State's COVID-19 Hotline (1-833-422-4255) should also be shared as hotline staff are available to respond to all questions related to COVID-19. Additional information can also be found at COVID-19 Treatment page.
Additional information for staff and clinicians can be found at COVID-19 Treatment Resources for Healthcare Providers.
*Tracking COVID-19 in California - COVID-19 Response