Providers, please encourage patients to stay up to date with COVID-19 vaccines and to contact you or another health care provider if they test positive, as both vaccination and treatment can reduce the chances of severe COVID-19 and hospitalization. You will find information below on current treatment options, vaccine resources for providers, current guidance documents, and more.
Oral antiviral treatment works by targeting specific proteins on the SARS-CoV-2 virus to prevent efficient virus replication within the host cell.
Paxlovid and molnupiravir reduce the risk of hospitalization and death by 88% and 30% respectively, in patients at high-risk for severe COVID-19 when started early after symptom onset.
As of November 1st, 2023, COVID-19 antivirals, Paxlovid and Lagevrio (molnupiravir), will begin their transition from United State Government distribution to traditional commercial channels. Please refer to the Commercialization section for more information regarding this transition.
- Have tested positive for COVID-19 and have had symptoms for 5 days or less.
- Are at high risk for progression to severe COVID-19, including hospitalization or death.
- Meet certain criteria depending on the antiviral.
The FDA also expanded approval of Veklury (remdesivir) to include pediatric patients 28 days of age and older weighing at least 3 kilograms (about 7 pounds) with positive results of direct SARS-CoV-2 viral testing who are:
- Hospitalized, or
- Not hospitalized and have mild-to-moderate COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization or death.
Health care providers should discuss the risks and benefits of treatment with their patients.
As of November 1st, 2023, both Lagevrio and Paxlovid will begin their transition from United State Government distribution to traditional commercial channels. Wholesale distributors anticipate having commercial orders filled within one to two weeks.
Any supply of U.S. government-issued therapeutics, including Paxlovid, must remain available to patients at no cost. Paxlovid should be dispensed to patients until the provider has commercial supply stocked. Moreover, Lagevrio should be dispensed to patients until depletion or expiration, whichever comes first. Once commercialized, programs will be established to ensure that Paxlovid is available to uninsured and underinsured individuals. Please refer to the Programs for Underinsured and Uninsured Individuals section for more information regarding these programs.
Paxlovid Disposal Management
Any expired product should be disposed of through the manufacturers return process or on site in accordance with federal, state, and local regulations.
Lagevrio Disposal Management
Product cannot be returned or disposed of unless expired (first expiry is in 2024). Once expired, product should be disposed of through the manufacturers return process or on site in accordance with federal, state, and local regulations.
USG Inventory Reporting
In accordance with the COVID-19 Therapeutics Provider Agreement, providers are expected to continue to provide reporting of all USG courses that they received and should report inventory, administration/dispensing, and disposal data until the provider’s USG product inventory is fully reconciled. Please do not record inventory or dispensing of commercially acquired inventory into HPOP, only USG product should be entered into current HPOP reporting fields.
Paxlovid and Lagevrio Expiry
The USG-procured supply has a distinct National Drug Code from the commercial EUA-labeled supply. The first lot expiry of government purchased Paxlovid began on July 31st, 2023, and most in field is later. The first lots of government purchased Lagevrio will begin expiring in February 2024 and the last in February 2025. Please continue to check the ASPR searchable expiration database for specific expiration dates.
For more information regarding the commercialization of Paxlovid, please refer to the COVID-19 Therapeutics Commercialization Transition Guide.
Programs for Uninsured and Underinsured Individuals
Paxlovid Patient Assistance Program (PAP)
Through December 31, 2024, anyone uninsured or covered by federal programs, such as Medicare or Medicaid, can receive USG procured, NDA-labeled Paxlovid at no cost through the USG PAP operated by Pfizer until 2028. Participating PAP dispensing sites will be sent replacement product for any dispensed product within this program.
Starting January 1, 2025, eligible uninsured and underinsured patients can receive USG procured, NDA-labeled Paxlovid at no cost. Participating PAP dispensing sites will be sent replacement product for any dispensed product within this program.
For retail pharmacies that would like to participate in the Patient Assistance Program, please contact the program vendor at [email protected] or call 1-877-219-7225.
Paxlovid Co-pay Savings Program
A co-pay savings program will be available for eligible commercially insured patients. More information will be provided shortly.
Lagverio Patient Assistance Program
This private and confidential program provides medicine, free of charge, for up to one year to eligible individuals, mostly the uninsured, who, without our assistance, could not afford needed Merck medicines. This program is expected to begin mid-November, 2023. For more information, please refer to the Merck Patient Assistance Program brochure or call 1-800-727-5400.
Lagevrio Bulk Replacement Program
For more information on the bulk replacement program, please call 1-888-727-8180.
HHS has created two resources to assist providers:
- A COVID-19 Therapeutics Locator which can be used to find locations with available Paxlovid or Molnupiravir.
- A Medication Locator which can be used to find Test to Treat locations and pharmacies to fill COVID-19 prescriptions.
- If you are within New York City, please refer to: COVID-19: Outpatient Therapeutic Information for Providers - NYC Health
Patients will require a prescription for Paxlovid and molnupiravir (Lagevrio).
Please contact the COVID-19 Therapeutics team at [email protected] if you have any questions and/or concerns.
Monoclonal Antibody (mAb) Therapeutics
Beginning in September 2021, the New York State Department of Health (Department) began managing the distribution process for monoclonal antibody (mAb) therapeutics within the State. There is no product currently available.
There are some products that were previously distributed but are not currently authorized for use in New York. These products are:
- Bamlanivimab/etesevimab (Lilly)
- Etesevimab (Lilly – to pair with bamlanivimab already on hand)
- Casirivimab/imdevimab, i.e., REGEN-COV (Regeneron)
- Sotrovimab (GlaxoSmithKline)
- Bebtelovimab (Lilly)
Please see the Oral Antivirals section for available treatments.
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New York State is seeking public health professionals to build public health capacity to increase preparedness for future health emergencies.
Licensed health care professionals are encouraged to register as a volunteer with ServNY to help with the State's response to a future public health emergency.