Paxlovid – information for health professionals

Last updated on July 2, 2024

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. It is indicated for adults who are moderate-to-severely immunocompromised, and/or 60 years or older with a high-risk chronic condition.

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 covered under Plan Z at no cost for B.C. residents with active MSP coverage.

Prescribers are encouraged to use the eForm for prescribing

Reduced patient need for Paxlovid

Paxlovid is unnecessary for most people living in B.C. The drug is only beneficial to groups that are considered at higher risk of progressing to serious illness, such as patients who are severely immunosuppressed. Since Paxlovid became available in January of 2022., B.C. residents have developed even stronger immunity to COVID-19 through previous infections and widespread vaccinations.

Treatment decisions should also consider safety risks, as Paxlovid is known to interact with many medications and is associated with adverse effects. Refer to COVID-19 Care Treatments for more information.

Prescribing guidance

BC PharmaCare has developed prescribing guidance for Paxlovid, which can be found on the eForm. The criteria indicates Paxlovid for:

  • Moderate-to-severely immunocompromised individuals
  • People aged 60 years and older with at least one high-risk health condition

For more information on prescribing, including dosing recommendations for renal patients, refer to BC CTC guidelines

Thumbnail of the Paxlovid prescribing eForm

Dispensing information

DIN Generic name Brand name Dosage form Maximum PharmaCare covers
02524031 nirmatrelvir/ritonavir Paxlovid 150 mg nirmatrelvir / 100 mg ritonavir tablets (30 tablets) $1391.99/package
02527804 nirmatrelvir/ritonavir Paxlovid 150 mg nirmatrelvir / 100 mg ritonavir tablets (20 tablets) $1391.99/package

Drug-drug interactions

Paxlovid has many drug-drug interactions. Please refer to BCCDC’s Practice Tool # 3, Lexicomp and University of Liverpool’s interaction checker for more information. 

Claims procedures

In PharmaNet, enter:

  • Drug cost: cost per package
  • Dispensing fee: $10 maximum
  • Quantity: 1 package

The Full Payment Policy applies to Paxlovid. Providers may not charge patients any costs associated with the dispense of Paxlovid.

Temporary clinical fees (PAX-A, PAX-F) were provided to pharmacists to dispense Paxlovid during the COVID-19 pandemic. The last fee concluded on December 31, 2023. 

Plan Z coverage

Plan Z coverage of Paxlovid is available only for B.C. residents with active Medical Services Plan (MSP) coverage. Exceptional Plan Z coverage is no longer available.

PharmaCare continually reviews its coverage policies for the products it covers. Any change to coverage for Paxlovid will be communicated in advance.

Resources

Additional resources - CanTreatCOVID and BC Cancer

CanTreatCOVID

CanTreatCOVID trial of treatments for COVID in community settings: https://cantreatcovid.org/about/

BC Cancer

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