(Nov. 3, 2023) – This week, the U.S. Department of Health and Human Services notified COVID-19 therapeutics manufacturers, distributors, pharmacies and the health care payer community that the commercialization transition process for Paxlovid and Lagevrio begins Nov. 1. For Paxlovid, during the transition and through the end of 2024, people who are uninsured and those who have Medicare or Medicaid coverage will continue to access Paxlovid with no out-of-pocket costs through Pfizer's new patient assistance program. Federal entities such as the Indian Health Service, the Department of Veterans Affairs and the Department of Defense will retain access to federally-acquired Paxlovid, as they have accessed the product for the last two years. HHS expects individuals with private insurance will continue to be able to access Paxlovid as coverage is established over the next few months. Pfizer also has stated it is setting up a co-pay savings program for those with private insurance, which will be independent of the patient assistance program.
Lagevrio is an option for eligible individuals who are unable to take Paxlovid or Veklury. HHS expects there to be commercial coverage for Lagevrio as well. For those who cannot afford the product, the Merck patient assistance program will be available to assist certain patients. For more information, see the HHS letter.
--Karen Braman