Oral Antivirals

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.

The FDA authorized two oral antivirals, Pfizer's Paxlovid and Merck's molnupiravir, for the treatment of COVID-19 in certain patients who:

• 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.

New York State is assigned a weekly allotment of both Paxlovid and molnupiravir (Lagevrio) from the U.S. Department of Health & Human Services (HHS).

• 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).

If you test positive for COVID-19 and do not have a regular health care provider, you can find a treatment provider using the COVID-19 therapeutics locator.

Requests for oral antiviral product should be submitted through the HHS Health Partner Order Portal (HPOP) as per the following directions:

1. Sign in to HPOP.
2. Navigate to the "Site Orders/Inventory" page.
3. Click on one of the buttons in the upper right corner, "Create an External Order" or "Create Order."
4. Select a response product type. In this case, click on the "COVID-19 / Therapeutic" button (in red).
5. Select your response product: Paxlovid, Renal Paxlovid or molnupiravir (Lagevrio).
6. Select the desired quantity of the product you are requesting.
7. Complete your order.

If you are having trouble accessing or navigating the HPOP system, please reach out to HPOP support at [email protected].

If you do not have an HPOP account, please follow the steps below.

1. Complete the COVID-19 Therapeutics Provider Enrollment Form within the Health Commerce System (HCD) here: https://mabrequest.health.ny.gov/nysmab/newprovider
   • If you do not have a HCS account, please visit the Health Commerce System website, and click on "Don't have an Account? Sign Up Here" to register for an account.
2. The New York State therapeutics team will review your enrollment form and will notify you if your form has been accepted, your form has been rejected, or if there is any other information needed from you to move forward with enrollment.
3. If accepted, the COVID-19 therapeutics team will send an email confirmation that you can log into the HPOP system and begin requesting COVID-19 therapeutics.

For immediate need of COVID-19 therapeutics, please contact your local pharmacy.

Reminder: All COVID-19 Oral Antivirals are currently distributed by the government and are available at no cost.

Step One – Complete the COVID-19 Therapeutics Provider Enrollment Form

Complete the form located within the Health Commerce System (HCS) here: https://mabrequest.health.ny.gov/nysmab/newprovider. 

Step Two – Create HPOP Account 

Once the Department has reviewed and approved your application, they will initiate the creation of an account on your behalf in the HHS Health Partner Order Portal (HPOP) system. You will receive a registration link via email from [email protected] with instructions to begin setting up your account. This link will expire within 72 hours, so it is important that registration is completed in a timely manner.

Step Three - Additional Information for HPOP Account

After registering, the following actions need to be taken in your HPOP account:

• Verify address. If your site is listed as a hub, please send your address, hours, and pharmacy contact (if different) to [email protected]. All hub addresses need to be verified by the state.
  • There is a checkbox below this field for receiving address which must be selected.
• Verify business hours.
  • There is a checkbox below this field for hours verified which must be selected
• Enter license number and expiration date (Ex. BoP, medical license, etc.).
• Select provider type and settings(s) where your facility will administer products
• Select the Therapeutics Category ‘Antiviral’ in your account

Step Four – Request Oral Antivirals

Once you’re HPOP account is active, you should follow the process outlined in the “Request Oral Antivirals” section to place orders.

Please contact the COVID-19 Therapeutics team at [email protected] if you have any questions and/or concerns.