The Biden administration is pressing pharmacies to ensure that patients with COVID-19 are not being charged thousands of dollars for Paxlovid.
Health and Human Services (HHS) Secretary Xavier Becerra met virtually this week with CEOs from Walgreens, CVS, Walmart and Kroger, as well as trade group leaders, to discuss the importance of pharmacist education and clear, accurate communication to patients about the costs of the COVID-19 treatment.
Pfizer’s COVID-19 antiviral has been underutilized despite its effectiveness at preventing hospitalization and death, likely due to the high cost and providers’ reluctance to prescribe it. The list price is nearly $1,400 for a five-day supply.
The federal government no longer distributes Paxlovid for free, so patients are subject to the commercial marketplace just like other prescription drugs.
According to HHS, the administration has been closely monitoring the commercialization process, including anecdotal reports that patients are being charged high co-pays or even the full price.
Becerra “made it clear that no patient should be charged hundreds of dollars for Paxlovid at the pharmacy counter,” HHS said in a readout of the meeting.
The Biden administration negotiated with Pfizer on ways to ensure the drug is affordable. Individuals on Medicare and Medicaid will be able to access Paxlovid for free through the end of 2024 through a patient assistance program, and uninsured individuals can receive Paxlovid for free through 2028.
Pfizer will operate a copay assistance program for individuals with commercial insurance through 2028.
“During Monday’s meeting, we briefed attendees on how we’re training our pharmacy teams and having them take extra steps to ensure affordable patient access. Additionally, we’ve provided HHS and Pfizer recommendations as to how the patient assistance program could be improved to reduce billing issues and increase access to the medication,” CVS said in a statement.