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Commercial Availability of Antiviral Medication for COVID-19
Oral antivirals
The oral antivirals Paxlovid (nirmatrelvir/ritonavir) and Lagevrio (molnupiravir) are now available on the commercial marketplace and are no longer distributed by the federal government. This will mean that some patients may have a co-pay for their prescription; however, patient assistance programs are available to cover the costs and medication will remain free or low-cost for most patients.
This page contains a general overview of patient assistance programs for continued access to these medications and information for pharmacies and healthcare facilities on the transition to traditional commercial distribution. For more detailed information, please refer to the following two guides from the U.S. Department of Health & Human Services (HHS), Administration for Strategic Preparedness & Response:
- Sunsetting the U.S. Government COVID-19 Therapeutics Distribution Program
- Frequently Asked Questions on the COVID-19 Therapeutics Transition to Commercial Distribution
NOTE: While MDH makes every effort to ensure the information on this page is accurate and up to date, this information is subject to change during this transition period.
Patient assistance programs (PAP)
Patients may face co-pays for COVID-19 antivirals. Providers are encouraged to assist patients with enrollment in a patient assistance program at the time of prescribing to obtain free medication or cover some or all of their out-of -pocket costs.
Patient assistance programs for COVID-19 oral antivirals
Paxlovid (nirmatrelvir/ritonavir)
Patient insurance status:
- Medicare
- Medicaid
- Other state/federal insurance program such as CHIP, Tricare, or VA
- Uninsured
- PAXCESS Patient Support Program
- Tel: 1-877-219-7225 (1-877-C19-PACK)
- Provides Paxlovid at no cost to eligible patients
Program uses US government purchased supply.
- Through December 31, 2024: Anyone uninsured OR covered by federal or state programs such as Medicare, Medicaid, CHIP, Tricare, or VA Community Care Network benefits can receive Paxlovid at no cost using this program.
- Starting January 1, 2025: Eligible uninsured OR underinsured patients can receive Paxlovid at no cost using this program.
- Patients may enroll themselves or be enrolled by their caregiver, provider or pharmacist to receive a voucher to use in participating pharmacies.
- Patients with Medicaid insurance can present their Medicaid card at the pharmacy and will be able to obtain free Paxlovid without having to enroll in this program.
- Health care providers enrolling patients will be directed to a separate platform to e-prescribe Paxlovid using provider and office verification via National Plan and Provider Enumeration System (NPPES) National Provider Identifier (NPI) numbers.
- NPI numbers for providers and organizations to complete enrollment may be looked up on the NPPES NPI Registry.
- Providers who would prefer to prescribe using their own prescription systems can enter the patient’s enrollment information using the Patient/Caregiver pathway to download a USG PAP program voucher for the patient to take to a participating pharmacy.
- Educational materials for patients and providers (brochures, one-pagers, flash cards) are available for download on Pfizer's Paxlovid Access-Support site.
Paxlovid (nirmatrelvir/ritonavir)
Patient insurance status:
- Commercial (private) insurance
- PAXCESS Patient Support Program OR
- Enroll in the Co-Pay Savings Program
- Provides co-pay assistance for Paxlovid to eligible patients.
- Patients with commercial insurance can enroll themselves or be enrolled by their provider or pharmacist to receive a co-pay card to cover up to $1500 per prescription or the amount of their co-pay, whichever is less.
- Card must be activated prior to use by calling 1-877-219-7225 (1-877-C19-PACK).
- If the patient has already filled the prescription, they may enroll in the program afterwards and apply for reimbursement.
- Providers may download up to 5 cards for distribution to patients at Pfizer: Download a co-pay card today!
- Educational materials for patients and providers (brochures, one-pagers, flash cards) are available for download on Pfizer's Paxlovid Access-Support site.
Lagevrio (molnupiravir)
Patient insurance status:
- Uninsured or whose insurance does not cover Lagevrio
- Call 800-727-5400 to make an Urgent Need request and follow the representative’s instructions to complete the enrollment form, available at: MerckHelps: LAGEVRIO.
- Provides Lagevrio at no cost to eligible patients.
- Patients who do not have insurance or whose current insurance coverage does not include Lagevrio may be eligible, depending on household income.
- Providers must call the program number for assistance when making a request. Enrollment forms should be faxed to Merck and medication will be sent to the patient’s address.
- Any address may be used, including shelters for persons experiencing homelessness, a physician’s office, or a long-term care facility.
- Telehealth providers may place an X on the form in lieu of a patient’s signature and include a line documenting that the visit was via telehealth on the cover page.
- Anyone currently in the US, including visitors and unauthorized immigrants, may qualify.
Other COVID-19 medications
Other COVID-19 medications that are available on the commercial marketplace include remdesivir and convalescent plasma. The U.S. Food and Drug Administration (FDA) has also authorized a monoclonal antibody for pre-exposure prophylaxis of COVID-19 in patients with moderate to severe immune compromise called pemivibart or Pemgarda™. Visit Therapeutic Options for COVID-19 Patients for information. Similar to other commercially available medications, there may be a cost for these medications as well as other costs associated with administration (such as receiving an IV infusion in a healthcare facility). Health insurance may cover some or all of these costs. Cost-sharing for COVID-19 monoclonal antibodies is prohibited for patients with Medicare Part D (refer to Centers for Medicare & Medicaid Services: COVID-19 Monoclonal Antibodies for details).
Patient assistance program for other COVID-19 antivirals
Veklury (remdesivir)
- Outpatient setting only
Patient insurance status:
- Commercial insurance
- Uninsured
- Underinsured
- Gilead's Advancing Access Program
- Tel: 1-800-226-2056
- Co-pay coupon program for commercially insured patients.
- Patient assistance program for uninsured or underinsured patients.
- Program can provide support with prior authorization and/or appeals process information
Transition to commercial distribution of oral antivirals
Beginning in November 2023, the distribution of COVID-19 antiviral medications will begin to switch from the federal government to the traditional commercial marketplace. This will mean that some patients with private health insurance will have a co-pay; however, the majority of patients will continue to be able to access medications at low or no-cost using patient assistance programs to cover costs. For example, patients on Medicare or Medicaid or who have no health insurance will be able to access Paxlovid free of charge through a Pfizer patient assistance program. For Paxlovid, any remaining U.S. distributed EUA-labeled product will no longer be authorized for use after March 8, 2024.
Federal entities
Federal entities such as the VA (Veterans Affairs), FQHCs (federally qualified health clinics), IHS (Indian Health Service) and DOD (Department of Defense) and others will continue to order US government supply beyond the date of transition to the commercial marketplace through end of 2024 until USG supply is depleted.
Pharmacies and patient assistance programs
Retail pharmacies are encouraged to participate in the USG PAP program operated by Pfizer to ensure that eligible patients can continue to access Paxlovid at no cost. Retail pharmacies can learn more about participating in the USG PAP by contacting the program vendor via email. Pharmacists may enroll patients into the patient assistance programs at the time of dispensing to ensure that eligible patients can access free or low-cost medications.