How to get Paxlovid when you need it

Key takeaways

• Paxlovid is an antiviral medication that can treat COVID-19 and reduce the risk of severe COVID-19 requiring hospitalization. It requires a prescription from a doctor or healthcare professional, including pharmacists.
• To be effective, Paxlovid must be taken within five days of the onset of COVID-19 symptoms, and eligibility is determined by a healthcare professional based on individual symptoms and medical history.
• The cost of Paxlovid can vary, but it may be free through Medicaid, Medicare Part B, or the Test to Treat program, though consultation costs may still apply.

Overview

Paxlovid is a brand-name medication used to help treat COVID-19. The drug contains a combination of two antiviral medications called nirmatrelvir and ritonavir, and it can help reduce the chance of developing severe COVID-19 symptoms. It may also help decrease the risk of hospitalization due to COVID-19 complications.

If you have COVID-19, Paxlovid may be a good treatment option for you.

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How to get Paxlovid

If you have tested positive for COVID-19 and you are considering taking Paxlovid, you must speak to a healthcare professional for a prescription. This will usually be a doctor, but in some cases, a pharmacist may also be able to prescribe Paxlovid.

The healthcare professional may ask you to complete a form about any known health conditions you have or any medications you currently take. After you receive your prescription, you should start taking the medication the same day.

You must take Paxlovid within the first 5 days from when you develop your first COVID-19 symptoms. Additionally, to be eligible for Paxlovid, you must:

• be an adult
• have a high risk of developing severe COVID-19 symptoms
• not have liver or kidney disease
• have not been hospitalized for previous COVID-19 treatment

Paxlovid also had Emergency Use Authorization to treat people ages 12 years and older weighing more than 88 pounds (lbs). Emergency Use Authorization is where the Food and Drug Administration (FDA) quickly approves a previously unapproved medication during public health emergencies, such as the COVID-19 pandemic.

If you meet these criteria, a doctor or healthcare professional will evaluate your symptoms and medical history before prescribing any antiviral medications.

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What does Paxlovid do?

Paxlovid is an oral antiviral medication for people who develop COVID-19 symptoms. This drug can help reduce the risk of severe illness and hospitalization in people who have recently tested positive for coronavirus.

A 2022 study found that in people who were unvaccinated for COVID-19, Paxlovid reduced the risk of hospitalization and severe illness by around 89%. A separate study of vaccinated people in the same year found that Paxlovid reduced this risk by more than half.

How Paxlovid works

The Paxlovid medication package contains two separate medications. In your 3-pill dose, you will get 2 pills containing nirmatrelvir and another with ritonavir as the active ingredient.

Nirmatrelvir is a viral inhibitor that helps treat COVID-19 by preventing the key enzymes the virus uses to reproduce. After you take nirmatrelvir, your symptoms begin to improve as the virus loses its ability to enter healthy cells in your body.

Ritonavir is a human immunodeficiency virus-1 (HIV-1) protease inhibitor. In the past, doctors used ritonavir as an HIV treatment. However, they have noticed that its properties can also help with COVID-19.

This is because ritonavir can shut down the metabolism in your liver, allowing nirmatrelvir to remain in your body for longer, helping you fight off the COVID-19 infection.

How to get Paxlovid

To get Paxlovid, you must speak with a healthcare professional. This can be via an in-person appointment, or you can use online telehealth appointments.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

After you receive your prescription, you can visit a local pharmacy or order your medication online from a qualified healthcare professional. Optum Perks, for example, offers home delivery on many medications.

However, if you order Paxlovid online, ensure you check when you will receive your package containing the medication. Remember that you must take Paxlovid within 5 days from when you first started experiencing COVID-19 symptoms.

What are the costs associated with Paxlovid?

A full course of Paxlovid treatment can sometimes cost more than $1,000, but this can vary. If you have health insurance, the cost can vary depending on your plan. While some people may have to cover the full cost of Paxlovid, other plans may ask you to cover only a part of the total cost.

Can you get Paxlovid for free?

If you qualify for Medicaid, you may not have to cover any costs for Paxlovid. Similarly, if you have a mild to moderate case of COVID-19 and you have Medicare Part B, you do not have to pay for Paxlovid.

Currently, Paxlovid is also available for free to people with commercial insurance through the manufacturer’s Paxcess savings program.

However, while you may get Paxlovid free, you must still consult a doctor to get a prescription. Therefore, depending on your insurance, you may have to cover the cost of the doctor’s office visit or online consultation.

If you don’t have insurance, you may be able to use coupons or savings cards, such as the Optum Perks Discount Card, to receive discounts on your medication.

Other drugs to help with COVID-19 symptoms

Paxlovid is not the only treatment for COVID-19. Other drugs that can help with COVID-19 symptoms may include:

• alternative antiviral medications, like:
  • molnupiravir (Legevrio)
  • sotrovimab (Xevudy)
  • remdesivir (Veklury)
• COVID-19 convalescent plasma from a donor

For people who are hospitalized with severe symptoms, doctors may give systemic corticosteroids, such as dexamethasone, to help reduce inflammation.

If Paxlovid is unsuitable for you, doctors can recommend the most appropriate alternative treatment option to help prevent any complications and reduce the risk of severe COVID-19 illness.

Summary

Paxlovid is a prescription-only antiviral medication, and you need to speak with a pharmacist or a doctor before you can access it. You must take Paxlovid within 5 days of your first COVID-19 symptom.

The medication treats COVID-19 symptoms and reduces the risk of developing severe illness and complications that may require hospitalization.

You can collect the medication from most local or some online pharmacies. You may have to pay for Paxlovid, but many insurers, including Medicare and Medicaid, cover the full cost. However, you may still have to cover the costs of the doctor’s consultation for the prescription.

While Paxlovid often successfully prevents serious COVID-19 illness, it may not suit everyone, and a doctor or healthcare professional can offer advice on alternatives where appropriate.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.