Treatments

Nirmatrelvir/Ritonavir (Paxlovid), is an oral antiviral medication shown to help people with lower immunity overcome the COVID-19 infection and reduce the chance of progression to hospitalization. Paxlovid is available in a pill combination that is taken twice a day for five days, and must be initiated within five days of symptom onset.

Since 2022, nirmatrelvir/ritonavir has been supplied by the federal government as a temporary, extraordinary measure at no cost to patients who met established criteria in Newfoundland and Labrador. The remaining federal supply of nirmatrelvir/ritonavir expired on May 31, 2024.

Nirmatrelvir/ritonavir is now commercially available and pharmacies can order and dispense through their usual processes for prescription medications. The approximate cost for a 5-day treatment course of nirmatrelvir/ritonavir is $1,450. The out-of-pocket cost to patients will depend on their drug coverage. To avoid delays in starting nirmatrelvir/ritonavir, high-risk patients should consult their prescribers to develop a treatment plan in advance of potential COVID-19 infection that includes a proactive assessment of drug coverage through their insurance and/or Newfoundland and Labrador Prescription Drug Program (NLPDP) as applicable.

Coverage

NLPDP coverage:

Paxlovid is now a benefit of the NLPDP for eligible beneficiaries.

You MAY be eligible for coverage of Paxlovid under NLPDP, with applicable co-pay, if you meet all of the following criteria:

  • You are a beneficiary of NLPDP
  • You have not been admitted to hospital (exceptions are made for patients in hospital but under Alternate Level of Care)
  • Your symptoms started within the last 5 days
  • You tested positive for COVID-19 within the last 5 days
  • You are moderately to severely immunocompromised and belong to one of the following high-risk groups:
    • You are a recipient of solid organ transplant
    • You are undergoing treatment for a malignant hematologic condition
    • You received a bone marrow or stem cell transplant in the past 2 years
    • You are taking transplant-related immunosuppressants
    • You have received anti-CD20 drugs or B-cell depleting drugs (such as rituximab) in the past 2 years
    • You have a moderate or severe primary immunodeficiency
    • You are undergoing treatment for cancer
    • You are receiving treatment with significantly immunosuppressing drugs (e.g., a biologic in the past 3 months, oral immune-suppressing medication in the past month, oral steroid [20 mg/day of prednisone equivalent taken on an ongoing basis] in the past month, or immune-suppressing infusion or injection in the past 3 months)
    • You have advanced HIV infection (treated or untreated)
    • You are on dialysis or have glomerulonephritis and dispensing of a steroid
  • You do not have a medical condition that would make treatment inappropriate
  • You are not taking medications that would result in a serious drug interaction with Paxlovid

If you are an NLPDP beneficiary and you think you may be eligible for treatment with Paxlovid, contact your pharmacist or primary care provider (family physician or nurse practitioner). They can complete the screening to ensure Paxlovid is an appropriate treatment for you.

If you are a NLPDP beneficiary and experiencing COVID-19 symptoms that started within the previous 5 days, your pharmacy is able to supply two rapid tests, free of charge, for the purposes of confirming the diagnosis.

Private insurance:

Patients with private insurance may be able to obtain full or partial coverage of nirmatrelvir/ritonavir depending on their plan and should confirm with their plan directly.

The Drug Identification Numbers (DIN) for nirmatrelvir/ritonavir products in Canada are:

  • nirmatrelvir 150 mg and ritonavir 100 mg dose packs (DIN 02524031)
  • nirmatrelvir 300 mg and ritonavir 100 mg dose packs (DIN 02527804)

No drug coverage:

Individuals who are not beneficiaries of the Newfoundland and Labrador Prescription Drug Program or do not have private insurance, will have to pay for Paxlovid.

For individuals who wish to determine whether they may be eligible for a NLPDP drug card, information regarding NLPDP drug card eligibility, including application forms, can be found at: Plan Overview – Health and Community Services (gov.nl.ca)

Treatment is No Substitute for Vaccination

Vaccination remains the best tool available to prevent hospitalizations and death due to COVID-19. Therapeutic treatment is an important and critical complement to vaccines, but it is important to acknowledge that vaccination and non-pharmaceutical public health measures remain the most important tools to prevent serious illness from COVID-19. Both the Public Health Agency of Canada and Health Canada strongly recommend vaccination for all eligible people living in Canada.

Visit Get the Shot – COVID-19 Vaccine (gov.nl.ca) for more information.