Contents: Paxlovid expiry dates | Background | Federal supply winding down | Drug-drug interactions (DDI) | Adjusting Paxlovid packages | Claims procedures | Patient counselling | Resources | Additional resources - CanTreatCOVID and BC Cancer
Most existing federal supply expired before or on March 31, 2024. Some lots of the renal impairment dose pack will expire on May 31, 2024. To extend the available supply, pharmacists are encouraged to dispense Paxlovid with the earliest expiry dates first, regardless of full dose or renal impairment dosing, adjusting tablets, instructions and counselling as needed. For supply that expired on March 31, 2024, pharmacists were encouraged to dispense Paxlovid only until March 26, 2024 to ensure the product did not expire part way through the five-day treatment course. For the limited supply that expires at the end of May 2024, dispense only until May 26, 2024.
To use full dose packaging (DIN: 02524031) for patient requiring renal impairment dose adjustment:
To use renal impairment dose packaging (DIN: 02527804) for patient requiring full dose:
Nirmatrelvir/ritonavir (Paxlovid™) is an oral antiviral treatment indicated to reduce the risk of hospitalization in adults with mild to moderate COVID-19 at high risk of progressing to severe COVID-19. Treatment is for a total of 5 days. If a patient remains symptomatic after 5 days of treatment, another course of Paxlovid is not indicated.
Paxlovid is supplied federally and covered under Plan Z at no cost for anyone in B.C., including residents and visitors. Read about Plan Z coverage of Paxlovid.
Prescribers are encouraged to use the nirmatrelvir/ritonavir (Paxlovid™) 5-day treatment pack prescription form (PDF, 1066KB).
The federal supply of Paxlovid is ending. B.C. pharmacies can continue to order federally-supplied Paxlovid through their regular suppliers until it runs out or expires. Paxlovid is currently under review for PharmaCare coverage.
Most existing federal supply expired before or on March 31, 2024. Some lots of the renal impairment dose pack will expire on May 31, 2024. To extend the available supply, pharmacists are encouraged to dispense Paxlovid with the earliest expiry dates first, regardless of full dose or renal impairment dosing, adjusting tablets, instructions and counselling as needed. Refer to Adjusting Paxlovid dispenses for instructions.
Consider carrying enough on hand to avoid treatment delays, as patients need to start treatment within 5 days of symptom onset.
Refer to Pfizer shelf-life correction – June 14, 2023 (PDF, 62KB) for lot numbers with expiry dates.
Paxlovid has many drug-drug interactions. It is recommended to refer to at least 2 interaction checkers before dispensing, such as BCCDC’s Practice Tool # 3, Lexicomp and University of Liverpool’s interaction checker.
To use full dose packaging (DIN: 02524031) for patient requiring renal impairment dose adjustment:
To use renal impairment dose packaging (DIN: 02527804) for patient requiring full dose:
In PharmaNet, enter:
If adjusting a regular dose for renal:
If a patient has renal dose adjustments and DDI(s):
If patient has DDIs and associated management plans:
If pharmacist determines it is inappropriate or unsafe to dispense Paxlovid:
The Full Payment Policy applies to Paxlovid. Providers may not charge patients any costs associated with the dispense of Paxlovid.
Plan Z coverage of Paxlovid is available for any patient receiving treatment in B.C., with exceptional coverage available for people in the MSP wait period, or visiting from a different home province or country. To apply, the prescriber or pharmacist calls the HIBC Help Desk. Be prepared to provide:
For information about patient eligibility, please consult BCCDC’s Practice Tool #1.
Pharmacies should dispose of expired federal supply as they would normally dispose of medications in their pharmacy, usually through a medication disposal bin. Do not return expired product to the distributor.
B.C. residents have developed strong immunity to COVID-19 through widespread vaccinations and previous infections. As such, Paxlovid is unnecessary for most people living in B.C. – the drug is only beneficial to groups considered at higher risk of progressing to serious illness.
PharmaCare previously paid two fees to pharmacists. Pharmacists claimed the PAX-F fee (ended March 31, 2023) for following up and monitoring patients for adverse drug events, and the PAX-A fee (ended December 31, 2023) for assessing Paxlovid prescriptions, including completing a drug-drug interaction (DDI) check with two independent sources.
Click to download:
CanTreatCOVID trial of treatments for COVID in community settings: https://cantreatcovid.org/about/
BC Cancer pharmacists are available to answer questions between 8am - 4pm Monday through Friday. Emails sent on weekends and statutory holidays will be responded to by a pharmacist the following working day. Refer to the table to contact the correct centre:
Centre | Pharmacist consult line |
---|---|
Abbotsford | Email: bcca_acacupharmacists@bccancer.bc.ca Phone: 604-851-4710 ext. 645242 |
Kelowna | Email: BCCA_CSIPharmacists@phsa.ca Phone: 250-712-3900 ext. 686758 |
Prince George | Email: cndan@bccancer.bc.ca Phone: 250-645-7317 |
Surrey | Email: BCCA_FVCCPharmacists@phsa.ca Phone: 604-930-4002 #2 |
Vancouver | Email: ACUPharmacist@phsa.ca Phone: 604- 877-6098 ext. 672632 |
Victoria | Email: VICACUPharm@bccancer.bc.ca Phone: 250-519-5500 ext. 693795 |
St. Paul's Hospital Ambulatory Pharmacy (HIV)