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COVID-19 Therapeutics Thresholds, Orders, and Replenishment

COVID-19 Oral Antivirals Transitioning to Commercial Marketplace

The federal government is transitioning COVID-19 oral antiviral treatments Paxlovid (nirmatrelvir packaged with ritonavir) and Lagevrio (molnupiravir) to the commercial market. To learn about upcoming milestones and timelines, see Sunsetting the U.S. Government COVID-19 Therapeutics Distribution Program.

See Important Dates

Ordering Paxlovid and Lagevrio

Paxlovid and Lagevrio are available for purchase via the commercial market as of November 1, 2023.  As part of the transition of COVID-19 therapeutics distribution to the commercial marketplace, ASPR has implemented the following protocols in accordance with its Sunsetting the U.S. Government COVID-19 Therapeutics Distribution Program:

  • Lagevrio ordering through the USG stopped on November 10, 2023.
  • Paxlovid orders through the USG will be accepted through December 15, 2023.

For more information about ordering, reporting, and using your supplies, please visit:

Federal Entities

Federal entities may continue to order Paxlovid from the U.S. government (USG) supply. Federal entities, excluding the Department of Defense and Veterans Affairs, may continue to order Lagevrio until supply is depleted. Ordering occurs through Health Partner Ordering Portal (HPOP)

State and Territory Officials

Jurisdictions and other partners should work with their providers/sites to deplete the USG supply in the field and replace inventory with commercial supply as needed.

Reporting Administration of Paxlovid and Lagevrio

The federal government tracks the amount of COVID-19 therapeutic products ordered and administered through the HPOP portal, monitoring product availability and administration of the USG-distributed products for each state or territory.

All disposal and returns of the USG-procured products need to be recorded in HPOP.

Returning Paxlovid

Through December 31, 2023, USG-distributed Emergency Use Authorization (EUA)-labeled Paxlovid with an expiration date of December 2023 or later is eligible to be returned for credit to the USG inventory. For each course of EUA-labeled Paxlovid with an expiration date of December 2023 or later that is returned, Pfizer will provide the USG with a credit as an NDA-labeled course for use in the USG Patient Assistance Program (USG PAP) operated by Pfizer and by federal entities.

For Paxlovid returns: 

COVID-19 Therapeutics Summary: USG Supplied Therapeutics Available for Patient Use1

December 17, 2021 – December 3, 2023

Therapeutic Courses Delivered Courses Administered2
Paxlovid3 18,400,748 11,145,083
Lagevrio
3,481,349 1,582,674
Total:
View Data by Jurisdiction
21,882,097 12,727,757

States, territories, and federal entities, including HRSA
Based on 90.2% of sites reporting this month
Includes Paxlovid and Reduced Dose Paxlovid

  • Data Source: Tiberius, Updated 12/04/2023 
  • Data through Sunday, 12/03/2023

COVID-19 Therapeutics Summary: Previous USG Supplied Therapeutics No Longer in Use

2020 – 2023

Therapeutics
(currently not in use*)
Date of
First Issue
Date of
Last Distribution
Courses
Delivered
Courses
Administered
Evusheld (300mg doses) December 8, 2021 January 26, 2023 1,032,156 738,936
Bebtelovimab February 11, 2022 November 30, 2022 739,889 624,633
Sotrovimab May 26, 2021 April 5, 2022 706,692 302,209
Bamlanivimab/Etesevimab February 9, 2021 January 24, 2022 642,125 610,753
REGEN-COV November 21, 2020 January 24, 2022 2,878,138 2,078,587
Bamlanivimab** November 9, 2020 March 2, 2021 664,691 N.A.

*Products are not currently authorized for use in any U.S region due to high frequency of SARS-CoV-2 subvariants to which these therapeutics are unlikely to be effective.

**EUA was revoked for bamlanivimab when administered alone; courses administered data are not available at this time.

COVID-19 Therapeutics Threshold Determinations

May 1, 2023 - November 26, 2023

Monthly Threshold Determinations* Paxlovid
(nirmatrelvir co-packaged with ritonavir;
standard and reduced dose)
Lagevrio
(molnupiravir)
Total
November 27, 2023 0 0
0
October 30 - November 26, 2023
2,452,230 0
2,452,230
October 2, 2023 - October 29, 2023
2,452,230 0
2,452,230
August 28 - October 1, 2023 2,452,230 195,299 2,647,529
July 31 - August 27, 2023 2,452,230 195,299 2,647,529
July 1 - July 30, 2023 2,452,230 195,299 2,647,529
June 1 - June 30, 2023 2,450,200 194,911 2,645,111
May 1 - May 31, 2023 2,450,200 194,911 2,645,111

*Starting May 2023, COVID-19 therapeutic threshold determinations were made on a monthly cadence. As of November 27, 2023, USG ended threshold determinations due to the transition of oral antivirals to commercial market. See the Sunsetting the U.S. Government COVID-19 Therapeutics Distribution Program for more information and a timeline of important dates.

Prior COVID-19 Therapeutic Product Efforts

Date Range Threshold/Distribution/Allocation by Jurisdiction
April 25, 2022 - April 30, 2023
COVID-19 Therapeutics Threshold Determinations
September 13, 2021 - April 24, 2022 COVID-19 Therapeutics Distribution
November 9, 2020 - March 2, 2021 Bamlanivimab Distribution
November 24, 2020 - February 2, 2021 REGEN-COV Distribution
July 6, 2020 - October 4, 2020 Allocation of Commercial Veklury (Remdesivir) (PDF)
May 4, 2020 - June 29, 2020
Allocation of Donated Veklury (Remdesivir)