Antiviral Therapy Resources for Providers: COVID-19

Designed for health care providers, facilities, and systems as a compilation of resources for determining eligibility and prescribing outpatient treatment for acute COVID-19.

Clinical considerations

Determining eligibility and choosing a treatment

• CDC: Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Professionals
  Patients with one or more of these conditions are at risk of progressing to severe COVID-19 and are eligible for antiviral treatment.
  
  
• HHS: Clinical Decision Aid for Outpatient Therapeutics
  Decision tree for high-risk adult and pediatric patients to determine outpatient treatment for mild to moderate COVID-19.
  
  
• Suggested Criteria for the Use of Outpatient Antiviral Therapy for COVID-19 in Children (PDF)
  MDH guidance on clinical conditions for providers to consider when prescribing outpatient antiviral therapies for COVID-19 in children.
  
  
• CDC: Overview of Testing for SARS-CoV-2
  Patients are eligible for antiviral treatment if positive for SARS-CoV-2 on direct viral testing (e.g., RT-PCR or antigen testing, not serology). Positive results from home tests are acceptable and confirmatory RT-PCR testing is not required by FDA.

Prescribing tools

Important considerations when prescribing treatment

• IDSA: Management of Drug Interactions with Paxlovid (PDF)
  Resource for clinicians with information on the management of the most commonly prescribed drug interactions with Paxlovid.
  
  
• University of Liverpool: COVID-19 Drug Interactions
  Tool to check drug interactions with COVID-19 medications, including Paxlovid. Providers may choose to consider this resource to inform treatment decisions.
  
  
• M Health Fairview: Management of Paxlovid Drug-Drug Interactions (PDF)
  Resource created for M Health Fairview facilities on the management of drug-drug interactions seen with Paxlovid. Other providers may choose to consider this resource to inform treatment decisions.
  
  
• Clinical Considerations for Prescribing Oral Antivirals
  MDH checklist of eligibility criteria to consider prior to prescribing molnupiravir (Lagevrio) or nirmatrelvir/ritonavir (Paxlovid).
  
  
• CDC/IDSA COVID-19 Clinician Call: All About Paxlovid; Plus Variants Update
  Webinar for clinicians on Paxlovid, including case examples. Link contains recording of webinar and downloadable materials

Accessing antiviral treatment

Where to access and prescribe

• Covid-19 Test to Treat Locator
  Enter an address or zip code to search for:
  • Locations with testing, medical visits and medication (Test-to-Treat)
  • Locations to fill a prescription
  • Pharmacy locations with available oral antiviral inventory (including type) can be found using this locator.
    
    
• HHS COVID-19 Therapeutics Locator
  National map displaying locations that have received supplies of COVID-19 therapeutics, including Paxlovid, molnupiravir, bebtelovimab, and Evusheld.
  
  
  Note: As of 3 p.m. on June 30, 2022, the MNRAP platform is no longer available for referrals. Providers who wish to refer a patient for bebtelovimab may use the HHS COVID-19 Therapeutics Locator to find health care facilities that have received shipments of COVID-19 therapeutics. Data in this locator is based on stock on hand reported by locations within the past two weeks and is not a guarantee of availability.
• Where to Access Oral Antiviral Therapy in Minnesota
  Patients or providers can contact health systems and clinics listed to ask about availability of oral antiviral medications or access the federal Test-to-Treat program.
  
  
• Remdesivir is available commercially and is not being distributed by the federal government. Due to logistical constraints, outpatient remdesivir is not widely available. Providers should check with their nearest hospital or infusion center to see whether outpatient remdesivir treatment can be arranged. Infectious disease consultation may be required.
  
  
• Bebtelovimab is expected to become commercially available on around Aug. 15, 2022. Facilities who have previously received monoclonal antibodies through the distributor (Amerisource Bergen) will receive an email from the distributor with instructions regarding commercial purchase. Facilities that have not previously received monoclonal antibodies and are interested in purchasing bebtelovimab should contact Amerisource Bergen at asdaccountsetup@amerisourcebergen.com to register for an account.
  
  
• Providers who are not currently receiving distributions of Evusheld, but are interested in small volume ordering (1-3 patient courses), may now place those orders directly with the federal government at EVUSHELD Small Volume Order Form. AstraZeneca has established a helpline for providers with questions about prescribing and ordering at 1-833-EVUSHLD (833-388-7453).

General resources

• FDA: Fact Sheet for Healthcare Providers: Emergency Use Authorization for Paxlovid (PDF)
  • FDA: Frequently Asked Questions on the EUA for Paxlovid
    
    
• FDA: Fact Sheet for Health Care Providers: Emergency Use Authorization for Molnupiravir (PDF)
  • FDA: Frequently Asked Questions on the EUA for Lageviro (molnupiravir)
    
    
• FDA: Fact Sheet for Healthcare Providers: Emergency Use Authorization for Bebtelovimab (PDF)
  • FDA: Frequently Asked Questions on the EUA of Bebtelovimab
    
    
• Gilead: Prescribing Information for Remdesivir (PDF)
  Updated prescribing information for use of remdesivir in adult and pediatric patients including in non-hospitalized patients.
  
  
• NIH: COVID-19 Treatment Guidelines
  Recommendations on treatment of COVID-19 from the National Institutes of Health COVID-19 Treatment Guidelines Panel.
  
  
• IDSA Guidelines on the Treatment and Management of Patients with COVID-19
  Last updated March 23, 2022
  
  
• COVID-19 Therapeutic Options for COVID-19 Patients
  Detailed information for providers about medications currently authorized for use by the Food and Drug Administration (FDA).
  
  
• COVID-19 Medications
  Basic information on antivirals and monoclonal antibody treatments for patients and caregivers.