COVID-19 Therapeutics

COVID-19 Therapeutics

This page is intended for health care professionals. For general information about COVID-19 treatment, please visit the COVID-19 Symptoms and Treatment page.

Several treatments have been authorized by the FDA for the 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:

  • 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 progression to severe COVID-19. Paxlovid is an oral antiviral taken for 5 consecutive days, while 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 Paxlovid

Health care providers can administer Evusheld (AZD7442, Tixagevimab / cilgavimab) for pre-exposure prophylaxis (PrEP) of symptomatic COVID-19, prior to exposure to the virus for prevention of COVID-19 in certain adults and pediatric patients. The drug can provide protection for those not expected to mount an adequate immune response following vaccination, including those who are immunocompromised, as well as those individuals for whom COVID-19 vaccination is not recommended. Evusheld is available at most hospitals in Vermont.

Find the best treatment with 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, bebtelovimab and Lagevrio. Most pharmacies in Vermont carry Paxlovid.
  • Bebtelovimab is available at most hospitals in Vermont. 
  • Remdesivir is administered via an IV infusion over 3 days at select hospitals in Vermont. 

Allocation and Distribution of COVID-19 Therapeutics

The federal government continues to supply states and jurisdictions with Paxlovid, Lagevrio, and Evusheld. Each jurisdiction sets a threshold for Paxlovid and Lagevrio and each Monday, the federal government replenishes products equal to the amount ordered the previous week. Evusheld follows a monthly schedule for replenishment. Thresholds for oral antivirals and Evusheld will continue to be determined on a pro-rata population basis.

Remdesivir and bebtelovimab can be purchased on the commercial marketplace. Given the high cost of bebtelovimab purchased commercially, please reserve existing bebtelovimab supply of federally-supplied bebtelovimab for under/uninsured patients.

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)

More RESOURCES

Websites

Videos & Webinars

Health Alert Network (HAN)

CONTACT US

For questions about COVID-19 therapeutics in Vermont, email [email protected].