U.S. pharmacists can now prescribe COVID pills. Canada should follow suit, experts say

The U.S. Food and Drug Administration (FDA) on Wednesday gave state-licensed pharmacists the green light to prescribe Pfizer’s COVID-19 pill — also known as Paxlovid — to eligible patients. In Canada, only some provinces allow this but the Canadian Pharmacists Association says that “pharmacists in every jurisdiction” should have the authority to recommend the antiviral treatment to those that need it.

“Pharmacists in every jurisdiction should be enabled to provide the necessary COVID-19 testing, prescribing and dispensing of Paxlovid for high-risk patients,” Danielle Paes, chief pharmacist officer at the Canadian Pharmacists Association told Global News Thursday.

“Authorizing pharmacists to prescribe can improve access to equitable care and encourage faster initiation of (COVID) treatment by streamlining the whole process within pharmacy – screening, assessing, prescribing, dispensing,” she added.

According to the FDA, the use of the pill, authorized to treat newly infected at-risk people to prevent severe illness, has jumped in recent weeks in the United States and the same thing is being reported in Canada, according to the Canadian Pharmacists Association.

Currently, only pharmacists in Quebec, Alberta, Saskatchewan and Newfoundland and Labrador have been authorized by the provincial health authorities to prescribe the antiviral treatment.

“You may be interested to know that pharmacist prescribing has increased uptake,” Tyler Gogo, a spokesperson for the pharmacists association, told Global News in an email Thursday.

“For instance, during the period following the authority being granted to pharmacists in Quebec, more than 68 per cent of Paxlovid treatments were prescribed by pharmacists,” said Gogo.

According to Health Canada, the antiviral Paxlovid can be given to adults 18 and older who test positive for COVID-19, experiencing mild to moderate illness and are at high risk of becoming seriously ill.

The agency currently recommends prioritizing severely immuno-compromised patients, people over 80 who haven’t had all their vaccine shots, and people over 60 living in remote and rural locations, long-term care homes and First Nations.

“This is a really helpful drug … it helps people who are at greatest risk from landing in hospital and succumbing to the illness,” Isaac Bogoch, infectious diseases specialist at the Toronto General Hospital, told Global News.

READ MORE: Isolate if you catch COVID again after taking Pfizer’s pill, U.S. CDC says

Since Paxlovid must be taken within five days after symptoms begin, Bogoch says authorizing pharmacists to prescribe the treatment  can help lower the barriers to accessing the drug and help people who need it take it sooner rather than later.

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“Pharmacists can directly link people with care, so I think (allowing them to prescribe Paxlovid) is a no-brainer,” he said.

Bogoch also notes that there a number of barriers to accessing this treatment that he believes pharmacies can help lessen. The first being awareness — not many people know about Paxlovid, he says.

“We certainly need to ensure that t everyone is aware that if they get COVID, and they have risk factors for severe disease, there’s something out there to keep you out of the hospital,” he said.

The second barrier is access to diagnostic testing. Bogoch says quick or easy access to a COVID-19 test is necessary to confirm if somebody is positive.

“We have somewhat limited access to diagnostic testing in many parts of the country. Certainly, it’s not even close to what it was before,” said Bogoch.

He also says that pharmacists are “the best on the planet” for looking at drug interactions.

They can look into a patient’s medical history and are equipped to do PCR or rapid testing with a decent turnaround time to confirm if someone is COVID-positive, Bogoch said.

Paes also echoed Bogoch’s sentiment by saying that “pharmacists are the medication experts and are well-positioned to help advise patients and other prescribers about the appropriateness of Paxlovid given the risk of drug interactions and how to adapt other medication therapies for the short course of Paxlovid treatment.”

The third and last barrier, Bogoch says, is that Canadians need prescriptions to get Paxlovid, but not everyone has the same degree of access to family physicians.

Pharmacists, on the other hand, are everywhere in the community, and can help improve access, he said.

“Pharmacies are an important pillar of our health-care system,” said Bogoch. “I think we obviously need to talk about capacity in the health-care system. With such limited capacity, why would we ignore one of the fundamental pillars of our health-care system?” he added.

READ MORE: Almost a third of people report lingering symptoms, long COVID study finds

In December 2021, the Government of Canada signed a deal with Pfizer for one million treatment courses of Paxlovid.

A spokesperson for the Public Health Agency of Canada (PHAC), Anna Maddison, said in an email Thursday that “a limited, initial supply of 30,000 treatment courses was made available to provinces and territories in January 2022.”

“To date, approximately 594,800 treatment courses have been distributed to provinces and territories, Correctional Services Canada, the Department of National Defence and Indigenous Services Canada,” she added.

Maddison said “PHAC expects to receive and distribute 398,500 more treatment courses between July and September 2022, with a total of 1.5 million treatment courses to be delivered by December 2022.”

In the meantime, Maddison said the provinces and territories are the ones responsible for determining how best to implement and manage the available supply of Paxlovid.

“Many provinces and territories have increased access to Paxlovid by expanding eligibility criteria and facilitating prescribing by general practitioners, nurse practitioners and/or dispensing through pharmacies,” she added.