Your Patient Needs Paxlovid — But Their Pharmacy Doesn't Have It

You've evaluated a high-risk patient with COVID-19 and moderate renal impairment, confirmed they're within the 5-day treatment window, screened for drug interactions, and determined that Paxlovid 150 Mg /100 Mg Dose Pack is the right choice. Then the patient calls back: their pharmacy is out of stock.

This scenario is increasingly common, especially during COVID-19 surges. The renal dose pack is stocked in smaller quantities than the standard formulation, and pharmacies can run out quickly. As a provider, there are concrete steps you can take to help your patients access this time-sensitive medication.

Current Availability of Paxlovid 150 Mg /100 Mg Dose Pack

Paxlovid is not in formal shortage per the FDA or ASHP. Pfizer maintains adequate commercial supply at the national level. However, pharmacy-level availability of the 150 Mg /100 Mg Dose Pack is inconsistent because:

• Pharmacies stock fewer renal dose packs (often 0–2 units) due to lower demand
• During COVID surges, even minimal demand can deplete inventory
• The $1,400–$1,800 per-course cost discourages pharmacies from maintaining large buffers
• Wholesaler restocking may take 24–48 hours — potentially exceeding the treatment window

Why Patients Can't Find It on Their Own

Patients face several barriers when trying to fill a Paxlovid prescription independently:

• Limited information: Patients don't know which pharmacies stock the renal dose pack vs. the standard pack
• Phone wait times: During surges, pharmacy phone lines can be backed up for 30+ minutes
• Time pressure: They're symptomatic, often feeling unwell, and running up against the 5-day treatment window
• Cost confusion: Patients may not know about financial assistance programs and may abandon the prescription when they hear the cash price

What Providers Can Do: 5 Practical Steps

Step 1: Check Availability Before You Prescribe

Before sending the prescription, check real-time pharmacy availability using Medfinder for Providers. This free tool shows which pharmacies near your patient's location currently have Paxlovid 150 Mg /100 Mg Dose Pack in stock. Sending the prescription to a pharmacy that already has it eliminates the most common access barrier.

Step 2: Send the Prescription to a Confirmed In-Stock Pharmacy

Once you've identified a pharmacy with stock, e-prescribe directly to that location. If your patient's preferred pharmacy is out, explain why you're routing the prescription elsewhere. Most patients appreciate the proactive help — especially when they're sick.

Step 3: Document High-Risk Status to Expedite Prior Authorization

Some insurance plans require prior authorization for Paxlovid. To minimize delays:

• Include the patient's high-risk criteria in the prescription notes (age, comorbidities, immunocompromised status)
• Document the COVID-19 diagnosis date and symptom onset date
• Note the eGFR value justifying the renal dose
• Reference the time-sensitive nature of treatment (must start within 5 days of symptom onset)

Step 4: Connect Patients With Financial Assistance

Cost can prevent patients from picking up their prescription. Proactively share these resources:

• PAXCESS Co-Pay Savings Card: Up to $1,000 in annual savings for commercially insured patients. Enroll at paxlovid.com/paxcess.
• U.S. Government Patient Assistance Program (USG PAP): Free Paxlovid for eligible uninsured or underinsured patients (income below $46,950 individual / $63,450 couple). Enrollment through paxlovid.iassist.com.
• Pfizer RxPathways: Additional assistance programs at pfizerrxpathways.com.

For comprehensive cost-saving strategies, direct patients to our Paxlovid savings guide.

Step 5: Have a Backup Plan Ready

If Paxlovid remains unavailable after steps 1–4, be prepared to pivot quickly. Have your alternative treatment pathway mapped out in advance (see below).

Alternatives When Paxlovid Is Unavailable

If your patient cannot access Paxlovid 150 Mg /100 Mg Dose Pack within a clinically acceptable timeframe, consider these alternatives:

Remdesivir (Veklury) — First-Line IV Alternative

A 3-day outpatient IV infusion course. Effective in high-risk patients and avoids the CYP3A4 interaction issues of Paxlovid. Requires access to an infusion center. Appropriate for patients with renal impairment (dose adjustment needed for eGFR <30 mL/min).

Molnupiravir (Lagevrio) — Second-Line Oral Alternative

Oral antiviral taken as 800 mg twice daily for 5 days. Less effective than Paxlovid in clinical trials but offers an accessible oral option when first-line treatments are unavailable. Not recommended in pregnancy.

For a detailed clinical comparison, see our Paxlovid alternatives guide.

Workflow Tips for Your Practice

Integrating these steps into your clinical workflow can improve Paxlovid access for all your patients:

• Bookmark Medfinder for Providers on clinic computers for quick availability checks
• Create a Paxlovid prescribing checklist that includes: renal function check, drug interaction screen, pharmacy availability verification, and financial assistance referral
• Build relationships with 2–3 local pharmacies (including at least one independent pharmacy) that reliably stock the renal dose pack
• Prepare patient handouts with PAXCESS enrollment information and Medfinder instructions so patients can self-advocate if needed
• Use telehealth follow-up to confirm the patient filled the prescription and started treatment — a quick check-in call can catch access problems before the treatment window closes

Final Thoughts

The 5-day treatment window for Paxlovid means that every hour matters. For patients who need the 150 Mg /100 Mg Dose Pack, the combination of limited pharmacy inventory, drug interaction complexity, and cost barriers can turn a straightforward prescription into a multi-day access challenge.

By checking availability proactively through Medfinder for Providers, routing prescriptions to stocked pharmacies, and connecting patients with financial assistance before they leave your office, you can significantly improve the odds that your patient starts treatment on time.

For the broader clinical picture, see our companion article: Paxlovid Shortage — What Providers and Prescribers Need to Know in 2026.