COVID-19 Therapeutics

Several treatments have been authorized by the FDA for outpatient treatment and prevention of COVID-19. Vermont follows the CDC’s guidance for COVID-19 treatment. For hospitalized patients, consult NIH’s Therapeutic Management of Hospitalized Adults With COVID-19. 

Clinicians should consider COVID-19 treatment in patients who meet ALL of the following criteria:

• Test positive for SARS-CoV-2 (with PCR or antigen test, including at-home tests).
• Have symptoms consistent with mild-to-moderate COVID-19. People with mild COVID-19 experience symptoms such as fever, sore throat, cough or headache, that do not affect the lungs and breathing. People with moderate illness have symptoms that affect the lungs like shortness of breath or difficulty breathing.
• Are within 5 days of symptom onset for Paxlovid or 7 days of symptom onset for Veklury.
• Have one or more risk factors for severe COVID-19.
• Are not hospitalized (except if considering Veklury).

Age remains the strongest risk factor for severe COVID-19. Therefore, we recommend considering treatment for all patients age 50 and older.

How to Select the Right COVID-19 Therapeutics

The antiviral drugs Paxlovid (ritonavir-boosted nirmatrelvir) and Veklury (remdesivir) are the preferred treatments for eligible adult and pediatric patients with positive results of direct SARS-CoV-2 viral testing and who are at high risk for severe illness. Paxlovid is an oral antiviral taken for 5 consecutive days. Veklury (remdesivir) is administered via an IV infusion over 3 days. Lagevrio (molnupiravir) may also be considered if no other therapeutic options are available.

Paxlovid Eligibility and Effectiveness Information Sheet  
Paxlovid Patient Eligibility Screening Checklist Tool for Prescriber 
Use the Liverpool Drug Interaction Checker when considering PaxlovidFind the best treatment using the COVID-19 Therapeutics Decision Aid (ASPR)
See chart of available therapeutics with links to product fact sheets (ASPR) 

How to Order COVID-19 Therapeutics

• Use the Therapeutics Locator Tool to find Paxlovid and Lagevrio.* Most pharmacies in Vermont carry Paxlovid.
• Veklury is administered via an IV infusion over 3 days at select hospitals in Vermont. 

*The Food and Drug Administration (FDA) no longer authorizes bebtelovimab or Evusheld for emergency use because they were found to be ineffective against the most widely circulating variants.

Allocation and Distribution of COVID-19 Therapeutics

The federal government no longer supplies states and jurisdictions with Paxlovid and Lagevrio. More information about sunsetting the USG Covid-19 therapeutics program can be found here: COVID-19 Therapeutics Commercialization Transition Guide | October 20, 2023 (hhs.gov) 

More information can be found in this letter to COVID-19 therapeutics manufacturers, distributors, pharmacies, and the health care payer community: Letter to COVID-19 therapeutics manufacturers, distributors, pharmacies and the health care payer community. | HHS.gov    

Remdesivir can be purchased on the commercial marketplace. The Food and Drug Administration (FDA) no longer authorizes bebtelovimab or Evusheld for emergency use because they were found to be ineffective against the most widely circulating variants.

Vermont hospitals and pharmacies interested in carrying or redistributing COVID-19 therapeutics should email [email protected]. 

COVID-19 Therapeutics Thresholds, Orders, and Replenishment by Jurisdiction (ASPR) 
COVID-19 Shelf-Life Extensions (FDA)