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Many readers shared with me their testimonials for Paxcess, the new program that helps patients get the covid-19 antiviral treatment Paxlovid free or at low cost.
Susan from New York, for instance, wrote that when she tried to fill her Paxlovid prescription, “I was quoted $693 with Medicare insurance and $1,600 without insurance.” After enrolling in Paxcess, she obtained Paxlovid free from the same pharmacy. Similarly, after Barbara from Virginia was charged a $200 co-pay, she contacted the Paxcess program and got a full refund for the co-pay.
Such experiences are heartening, since they show the program is working as it should. However, it’s clearly a problem that patients often have to bring it up themselves.
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Consider this account from Deb from New York: “My doctor had no issues prescribing Paxlovid because of my age and immunocompromised status,” she wrote. “But while the pharmacy knew about the program, they did not tell me about it until I pressed. They vaguely talked about registering but not with whom or why. I called the number myself and was delighted to find out once I signed up, it would be free.”
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Even doctors aren’t immune to the runaround. After Ben, a physician from Louisiana, prescribed Paxlovid for an elderly couple on Medicare, he was aghast to learn that the pharmacy quoted them a combined cost of more than $1,400. Ben called the pharmacy himself, to no avail. Eventually, one of his patients found Paxcess through “online sleuthing,” and the couple got the pills free.
Some people were upset that they couldn’t sign up for the program until they had a prescription in hand. “I tried to enroll online but the very first question the website asks is if you have been prescribed Paxlovid,” wrote Dominque from North Carolina. “I don’t want to wait until I’m sick to figure out how much I have to pay for my medicine. Is there a way to pre-enroll? And if no, why not?”
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I posed this question to Pfizer, which runs Paxcess. A representative explained that while it’s not possible for the company to pre-enroll people without prescriptions, it should take less than five minutes to sign up. After going through the process with several patients, I think this is true. Enrolling is very straightforward, and approval happens within seconds, so people can essentially consider themselves “pre-enrolled” already.
Knowing that many pharmacies are not yet proactively bringing up Paxcess, I advise patients to fill out the online form as soon as they have a prescription. And they should have their voucher in hand when they go to pick up the medication.
Hilary from Florida asked a great question: “Since covid is ubiquitous, why can’t you take a covid test at the pharmacy and have the pharmacist confirm the diagnosis and dispense Paxlovid?”
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In fact, the federal government has issued guidance allowing pharmacists to prescribe Paxlovid themselves, bypassing the need for a doctor’s visit. But there are four important caveats:
First, the patient has to come with bloodwork drawn within the past 12 months documenting their kidney and liver function. This is a major barrier. A representative from Walgreens told me that as many as 75 percent of patients seeking pharmacist assessments do not have the requisite bloodwork.
Second, Paxlovid has interactions with many drugs. Most can be managed to allow patients to take Paxlovid, but pharmacists don’t have the authority to do this. So if the patient is on medications that need to be adjusted or temporarily stopped, the pharmacist will refer them back to their physician or, if they don’t have a primary-care provider, help them find one who can assess their medical situation.
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Third, pharmacist assessments are generally not covered by insurance. Many patients will have to pay out of pocket to see the pharmacist. CVS cited a cost of $60 per patient and Walgreens $44.99. So even if the medication ends up being free through Paxcess, patients might be on the line for the cost of the pharmacist evaluation.
Fourth, though licensed pharmacists are legally able to offer this service, not all pharmacies have this option. CVS and Walgreens do through a nationwide virtual program. (Many of their sites also have a walk-in medical clinic for patients to see a doctor, nurse practitioner or physician assistant who can do their medical assessment and prescribe Paxlovid.) But Rite Aid informed me that while all of its locations “dispense covid oral antivirals with a prescription,” they “do not test/treat for covid.” The practices will differ at box stores and independent pharmacies.
All of these reasons explain why less than 1 percent of the prescriptions for Paxlovid filled by Walgreens are written by a pharmacist, as a company representative told me.
My takeaway here is that pharmacist prescriptions are a good option for a select group of patients with relatively uncomplicated medical histories. These individuals should contact the pharmacy of choice in advance to verify this service is available, bring recent blood testing results and be prepared to pay out-of-pocket for the visit.
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You’re reading The Checkup With Dr. Wen, a newsletter on how to navigate covid-19 and other public health challenges. Click here to get the full newsletter in your inbox, including answers to reader questions and a summary of new scientific research.
Many readers shared with me their testimonials for Paxcess, the new program that helps patients get the covid-19 antiviral treatment Paxlovid free or at low cost.
Susan from New York, for instance, wrote that when she tried to fill her Paxlovid prescription, “I was quoted $693 with Medicare insurance and $1,600 without insurance.” After enrolling in Paxcess, she obtained Paxlovid free from the same pharmacy. Similarly, after Barbara from Virginia was charged a $200 co-pay, she contacted the Paxcess program and got a full refund for the co-pay.
Such experiences are heartening, since they show the program is working as it should. However, it’s clearly a problem that patients often have to bring it up themselves.
Consider this account from Deb from New York: “My doctor had no issues prescribing Paxlovid because of my age and immunocompromised status,” she wrote. “But while the pharmacy knew about the program, they did not tell me about it until I pressed. They vaguely talked about registering but not with whom or why. I called the number myself and was delighted to find out once I signed up, it would be free.”
Even doctors aren’t immune to the runaround. After Ben, a physician from Louisiana, prescribed Paxlovid for an elderly couple on Medicare, he was aghast to learn that the pharmacy quoted them a combined cost of more than $1,400. Ben called the pharmacy himself, to no avail. Eventually, one of his patients found Paxcess through “online sleuthing,” and the couple got the pills free.
Some people were upset that they couldn’t sign up for the program until they had a prescription in hand. “I tried to enroll online but the very first question the website asks is if you have been prescribed Paxlovid,” wrote Dominque from North Carolina. “I don’t want to wait until I’m sick to figure out how much I have to pay for my medicine. Is there a way to pre-enroll? And if no, why not?”
I posed this question to Pfizer, which runs Paxcess. A representative explained that while it’s not possible for the company to pre-enroll people without prescriptions, it should take less than five minutes to sign up. After going through the process with several patients, I think this is true. Enrolling is very straightforward, and approval happens within seconds, so people can essentially consider themselves “pre-enrolled” already.
Knowing that many pharmacies are not yet proactively bringing up Paxcess, I advise patients to fill out the online form as soon as they have a prescription. And they should have their voucher in hand when they go to pick up the medication.
Hilary from Florida asked a great question: “Since covid is ubiquitous, why can’t you take a covid test at the pharmacy and have the pharmacist confirm the diagnosis and dispense Paxlovid?”
In fact, the federal government has issued guidance allowing pharmacists to prescribe Paxlovid themselves, bypassing the need for a doctor’s visit. But there are four important caveats:
First, the patient has to come with bloodwork drawn within the past 12 months documenting their kidney and liver function. This is a major barrier. A representative from Walgreens told me that as many as 75 percent of patients seeking pharmacist assessments do not have the requisite bloodwork.
Second, Paxlovid has interactions with many drugs. Most can be managed to allow patients to take Paxlovid, but pharmacists don’t have the authority to do this. So if the patient is on medications that need to be adjusted or temporarily stopped, the pharmacist will refer them back to their physician or, if they don’t have a primary-care provider, help them find one who can assess their medical situation.
Third, pharmacist assessments are generally not covered by insurance. Many patients will have to pay out of pocket to see the pharmacist. CVS cited a cost of $60 per patient and Walgreens $44.99. So even if the medication ends up being free through Paxcess, patients might be on the line for the cost of the pharmacist evaluation.
Fourth, though licensed pharmacists are legally able to offer this service, not all pharmacies have this option. CVS and Walgreens do through a nationwide virtual program. (Many of their sites also have a walk-in medical clinic for patients to see a doctor, nurse practitioner or physician assistant who can do their medical assessment and prescribe Paxlovid.) But Rite Aid informed me that while all of its locations “dispense covid oral antivirals with a prescription,” they “do not test/treat for covid.” The practices will differ at box stores and independent pharmacies.
All of these reasons explain why less than 1 percent of the prescriptions for Paxlovid filled by Walgreens are written by a pharmacist, as a company representative told me.
My takeaway here is that pharmacist prescriptions are a good option for a select group of patients with relatively uncomplicated medical histories. These individuals should contact the pharmacy of choice in advance to verify this service is available, bring recent blood testing results and be prepared to pay out-of-pocket for the visit.
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