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COVID-19 Oral Antiviral Therapeutics Program

New Add-On Option: Direct to Patient Prescribing

Express Scripts PBM, part of Evernorth health services, is now offering current clients expanded access to the COVID-19 antiviral medication PaxlovidTM at the pharmacy with Direct to Patient Prescribing.

Pharmacists have been granted prescribing authority from the Food and Drug Administration (FDA), allowing them to prescribe PaxlovidTM to patients testing positive for COVID-19 and meeting clinically-appropriate criteria.
Previously only physicians could prescribe the antiviral drug.

The COVID-19 Oral Antiviral Therapeutics Program includes:
  • Access to the broadest retail pharmacy network offered by Express Scripts PBM
  • Addition of FDA-approved COVID-19 antiviral therapeutic medications to your formulary
  • Member education communication template for your use
  • $0 member copay1 for the prescription
  • $0 ingredient cost while funded by the Federal government
  • $12 dispensing fee
  • $2.50 per claim program fee2
  1. May not apply for all plan sponsors, but is recommended to align with the federal government’s expectations.  
  2. Does not apply to fully insured EGWP
Enrolling in the Direct to Patient Prescribing for Paxlovid add-on option includes everything listed to the left, plus:
  • Member access to participating pharmacies nationwide
  • $0 member copay for pharmacist visit and Paxlovid prescription
  • $60 Professional Service Fee: compensates pharmacist’s time to gather the necessary medical data for appropriate prescribing
  • Initial implementation fee and a discounted recurring annual fee thereafter, dependent on the plan life count, as outlined here (opens in new tab)
  • Member education communication template for your use, provided upon enrollment. Additional materials will be provided soon after.
  • Go-live by early November

Enroll Now

Thank you.
Thank you for enrolling in Direct to Patient Prescribing for Paxlovid. Click below to download our member education communication template for your use! If you have questions, contact your account representative.

If you need to enroll more than one carrier, PLEASE READ CAREFULLY:
1. You should have received an email from Express Scripts for each carrier ID in your account.
2. Please use the link provided in each email, which will pre-populate the form with a new carrier ID.
3. If you did not receive multiple emails and still want to enroll more carriers, gather applicable Carrier ID numbers and reach out to your Express Scripts account representative for assistance.