Paxlovid prescribing privileges extended to pharmacists

The FDA widened the antiviral’s emergency authorization to allow for pharmacists to write prescriptions. Not everyone is pleased.

Marc Iskowitz

July 8, 2022

2:15 pm

PEMBROKE PINES, FLORIDA – JULY 07: In this photo illustration, Pfizer’s Paxlovid is displayed on July 07, 2022 in Pembroke Pines, Florida. The US Food and Drug Administration revised the emergency use authorization for Paxlovid, Pfizer’s Covid-19 antiviral treatment, to allow state-licensed pharmacists to prescribe the treatment to people. (Photo by Joe Raedle/Getty Images)

The Food and Drug Administration said this week it was authorizing state-licensed pharmacists to prescribe Pfizer antiviral drug Paxlovid.

Pharmacists had been advocating for the agency to grant them the ability to prescribe the drug. They said it would widen access to the antiviral, which is authorized for the treatment of “mild-to-moderate” COVID-19 in adults and pediatric patients that have tested positive and are considered to be at high risk of developing severe disease.

“Removing barriers to pharmacist prescribing of oral antivirals has the potential to be a game-changer for addressing health equity and providing timely access to these life-saving treatments in pockets of the country where pharmacists may be the only healthcare provider for miles,” said Ilisa Bernstein, interim EVP and CEO of the American Pharmacists Association, in a statement.

But the country’s largest doctor group, the American Medical Association, says patients will get the best, most comprehensive care from physician-led teams.

Paxlovid, noted Dr. Jack Resnick, Jr., AMA president, “is not for everyone and prescribing it requires knowledge of a patient’s medical history, as well as clinical monitoring for side effects and follow-up care to determine whether a patient is improving – requirements far beyond a pharmacist’s scope and training.”

In related news, Paxlovid’s contraindications have taken on greater importance, particularly outside the US, where a rival COVID-19 antiviral from Merck is often prescribed more frequently despite its lower efficacy, according to a report in The Wall Street Journal.

Australia, Japan and Italy are among countries where Merck’s Lagevrio (molnupiravir) has been administered to patients more than Pfizer’s drug, the paper noted, with the trend reflecting doctors’ preference for a low risk of potential drug interactions over efficacy. Early data showed Paxlovid does a better job than Lagevrio at keeping people out of the hospital.

Analysts have adjusted their yearly revenue forecasts accordingly. The forecast for Paxlovid was scaled back to a still-high $24.8 billion, with sales of Lagevrio now expected to reach $5.4 billion this year, per the Journal.