The Department of Health and Human Services Oct. 27 urged Merck and Pfizer to work with private insurers to maintain access to their COVID-19 oral antiviral medications as they transition from federal to commercial distribution, beginning Nov. 1. Health care providers and distributors may continue to order Merck’s Lagevrio from the federal government until Nov. 10 and Pfizer’s Paxlovid from the federal government until Dec. 15.
“Beyond these dates, all providers should ensure that they order sufficient commercial product after November 1 ahead of that transition,” HHS said in a letter to manufacturers, distributors, pharmacies and insurers. “Based on lessons learned during the transition to commercial distribution for vaccines, we want to underscore the public health importance of reducing barriers to coverage however possible and urge you to consider any and all ways to reduce these barriers. It is critical to help members navigate insurance networks. If you encounter any operational problems that impede patient access to these treatments, we expect you to inform HHS immediately so the Department can facilitate collaboration across the health care landscape, as it has done before.”
For more on the transition and its impact on provider ordering, reporting requirements, and inventory management and programs to help uninsured and underinsured individuals access the drugs, see this recent HHS guidance.