Rate of dispensing Paxlovid up 130 per cent since Ontario pharmacists were allowed to prescribe

The rate of dispensing Paxlovid—an oral antiviral treatment for COVID-19—increased by more than 130 per cent since pharmacists were permitted to prescribe the medication, the Ontario government says.

Pharmacists have been able to prescribe Paxlovid to patients since Dec. 12. Prior to that date, Ontarians needed a prescription from a doctor or clinical assessment centre in order to access the treatment.

Justin Bates, CEO of the Ontario Pharmacists Association (OPA), said it made sense for pharmacists to help prescribe Paxlovid because of the short timeframe in which it should be taken.

The medication works best when taken within five days of the onset of symptoms, officials have said. Once obtained, patients take two doses each day for five days.

“That turnkey solution in a pharmacy to be able to assess, prescribe and dispense is really important,” Bates said.

“Just like minor ailments, it eliminates the need to go to multiple places, and it increases the timeliness of the care and recovery time. So for us, I think it’s been successful.”

According to the Ministry of Health, there has been a 131 per cent increase in the rate of Paxlovid dispensing since Dec. 12.

In total, the ministry says more than 101,000 prescriptions have been dispensed in Ontario by pharmacists, physicians and nurse practitioners.

Paxlovid is only available to those at high risk of severe illness or hospitalization as a result of COVID-19.

• What you need to know about getting Paxlovid

While the treatment is relatively easy for patients to take at home, experts say it is also quite a complex medication with “a huge number of drug interactions.”

“It can be really complicated to prescribe,” Kelly Grindrod, an associate professor at the University of Waterloo’s School of Pharmacy, told CTV News Toronto.

“In that way, it actually makes a lot of sense for pharmacists, who focus on having that correct drug list and managing that, to prescribe it because they actually do understand how to mitigate things, how to adjust other therapies, what to look for.”

FILE - In this Nov. 5, 2018 file photo, a drugstore employee reaches for medicine from shelf in downtown Tehran, Iran. (AP Photo/Ebrahim Noroozi)

Grindrod says there are dozens of medications that could interact with Paxlovid, including common pills that manage cholesterol and blood pressure. However, pharmacists understand how these interactions can be managed and can adjust dosages accordingly.

“It is what pharmacists do,” she said.

Just under a month after pharmacists began to prescribe the COVID treatment, their responsibilities were expanded to include the ability to prescribe medication for 13 common ailments.

The 13 conditions include hay fever, oral thrush, dermatitis, pink eye, menstrual cramps, acid reflux, hemorrhoids, cold sores, impetigo, insect bites and hives, tick bites, sprains and strains, and UTIs.

Minister of Health Sylvia Jones said at the time the move will provide Ontarians with more convenience and will “free-up doctors” to provide care for more complex needs.

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As of the first week of January, it is unclear how many pharmacies are actually prescribing these medications. Bates said he believes the majority of OPA’s members will be providing the service at some point this month; although it may take a bit more time for others to ramp up the staffing and infrastructure needed to do so.

“I do believe that based on our anecdotal evidence, and in talking to our members, that the majority will offer this within the next 30 days, if they're not already,” he said.

PRESCRIPTIONS BY APPOINTMENT

Bates said that most pharmacies will be using an appointment-based system, which will allow patients to book sessions similarly to how they would get their flu or COVID-19 vaccines.This, he said, will allow pharmacies to staff appropriately.

Walk-ins may be accepted at some locations.

CTV News Toronto has asked the Ministry of Health how many pharmacies have said they will be offering prescribing services and was told that “new numbers” would be available sometime next week.

While the idea of pharmacists being able to prescribe more medications is a new one to Ontario, most provinces in Canada have already implemented a similar program.

“Ontario is actually a fair way behind other provinces,” Grindrod said. “Most other provinces had some variation of the minor ailments programming for quite a while. In some places like Saskatchewan, it's been over 10 years.”

Grindrod said that prior to these changes, pharmacists were already doing the leg work for these prescriptions–answering questions patients may have about their ailments, addressing drug interactions, and adjusting dosages when necessary.

“The real change here is the pharmacists are actually being paid for that work that they were already doing.”