For both treatments: Providers should continue to order and dispense U.S. Government (USG)-procured Paxlovid and Lagevrio to allow sufficient time for the specific patient assistance programs to ramp up. Once these programs ramp up:
Medicare, Medicaid, and uninsured patients will continue to receive Paxlovid at no charge through 2024 through the USG Patient Assistance Program (PAP) operated by Pfizer. This includes all patients who are publicly insured through Medicare (with or without Part D, Part B, or Part C and inclusive of Medicare Advantage), Medicaid/CHIP, TRICARE, and patients insured through the VA Community Care Network. The USG PAP using USG-procured supply (commercial, NDA-labeled) is anticipated to start December 1, 2023.
Separately from the USG PAP, federal entities, including Health Resources and Services Administration (HRSA)-supported health centers, Indian Health Service, Veterans Health Administration and others, will have continued access to free, USG-procured Paxlovid supply for their patients similar to how they have accessed Paxlovid in the past. USG-procured Paxlovid may also be used to support state, local, tribal, or territorial special programs targeting vulnerable populations on a case-by-case basis.
Concurrently, Pfizer will operate a Paxlovid Co-Pay Savings Program for eligible privately (commercially) insured patients. This program is accessible through
Paxlovid.com for patients and
Paxlovid.pfizerpro.com for health care providers.
The Merck Patient Assistance Program (a 501c3 non-profit organization) will provide Lagevrio free of charge to patients who meet its eligibility criteria and who, without assistance, could not otherwise afford the product. This program is anticipated to start in mid-November.
In addition, USG-procured Lagevrio will continue to be distributed to certain federal entities, including HRSA-supported health centers, Indian Health Service, and others until USG supply is depleted.