Your Patient Needs Paxlovid — Now What?

You've evaluated your patient, confirmed they're at high risk for severe COVID-19, screened for drug interactions, and determined that Paxlovid (Nirmatrelvir/Ritonavir) is the right treatment. Now comes the part that shouldn't be hard but often is: making sure they can actually get it.

In 2026, prescribing Paxlovid and having your patient fill it within the critical treatment window are still two separate challenges. This guide outlines practical steps your practice can take to bridge that gap.

Current Availability: The Ground-Level Reality

Nationally, Paxlovid supply exists. Pfizer continues manufacturing, and the drug is not on the FDA shortage list. But local availability is another story:

• Many retail pharmacies don't stock it routinely due to the $1,400-$1,600 wholesale cost and shelf-life concerns
• Chain pharmacies (CVS, Walgreens, Walmart) are more likely to carry it, but not at every location
• Independent pharmacies vary widely — some stock it consistently, others never carry it
• Hospital outpatient pharmacies often have it but are underutilized for outpatient prescriptions
• Winter COVID surges can deplete local stock within days

The bottom line: assuming your patient will have no trouble finding Paxlovid at their usual pharmacy is optimistic. A proactive approach from your practice makes a meaningful difference.

Why Patients Struggle to Find Paxlovid

Understanding the barriers your patients face helps you anticipate and address them:

Time Pressure

Paxlovid must be started within 5 days of symptom onset. Patients who test positive on day 3 or 4 have very little margin for error. If their first pharmacy doesn't have it, they may give up rather than keep searching.

Cost Shock

Patients without insurance or with high-deductible plans may face the full $1,400-$1,600 cash price. Even patients with insurance may encounter unexpected copays. Cost surprise at the pharmacy counter is a leading cause of fill abandonment.

Lack of Awareness

Many patients don't know that pharmacy stock varies widely for this medication. They assume that if their doctor prescribed it, their pharmacy will have it. When it's not there, they may not know what to do next.

Drug Interaction Complexity

Some patients are told at the pharmacy that Paxlovid can't be filled because of a potential interaction — without guidance on what to do next. This is especially common in patients on statins, blood thinners, or immunosuppressants.

What Providers Can Do: 5 Actionable Steps

Step 1: Verify Stock Before Sending the Prescription

This single step can prevent most fill failures. Before sending a Paxlovid prescription to your patient's preferred pharmacy, check whether that pharmacy actually has it in stock.

Medfinder for Providers offers real-time pharmacy inventory data. Your staff can search by the patient's zip code and identify pharmacies with confirmed stock in seconds. Send the prescription to a pharmacy you know has it.

Step 2: Proactively Address Cost

At the point of prescribing, inform your patient about cost and assistance options:

• Pfizer's PAXCESS program: Insured patients may pay $0 (up to $1,500 savings per Rx); uninsured patients may qualify for free medication. Enrollment at paxlovid.com/paxcess or 1-877-219-7225.
• Discount cards: GoodRx, SingleCare, and similar platforms sometimes offer Paxlovid pricing, though savings vary.
• Remind patients to bring their insurance card and mention PAXCESS at the pharmacy if cost is a concern.

For a detailed breakdown to share with patients: How to Save Money on Paxlovid 5-Day.

Step 3: Screen for Drug Interactions Early

Don't let the pharmacy be the one to flag a problem. Screen for CYP3A4 interactions before prescribing and make necessary adjustments:

• Temporarily hold lovastatin, simvastatin, or atorvastatin during the 5-day treatment and for 2-3 days after
• Adjust anticoagulant dosing or switch to monitoring protocols for warfarin patients
• Consult with transplant or specialty teams if the patient is on immunosuppressants — tacrolimus and cyclosporine levels can increase dramatically
• Consider Lagevrio for patients with too many interactions to manage safely in the 5-day window

The NIH COVID-19 Treatment Guidelines drug interaction checker and the Liverpool COVID-19 interaction tool are both reliable rapid-screening resources.

Step 4: Have Backup Plans Ready

Know your local treatment alternatives before you need them:

• Lagevrio (Molnupiravir): Oral, 5-day course, fewer interactions, available under EUA. Less effective than Paxlovid but a reasonable backup, especially for patients with interaction concerns.
• Remdesivir (Veklury): 3-day outpatient IV infusion. Identify local infusion centers that offer it. Many hospital outpatient departments can administer it.
• Monoclonal antibodies: Check current FDA authorizations, as availability depends on circulating variants.

Having these alternatives mapped out in advance saves critical time when Paxlovid isn't available.

Step 5: Empower Your Patients

Give patients actionable next steps if they run into problems at the pharmacy:

• Share Medfinder as a resource for finding pharmacies with stock
• Provide a printed or digital handout with PAXCESS enrollment information
• Tell them to call your office if the pharmacy says they can't fill it — don't let them just walk away
• If appropriate, share our patient guide: How to Find Paxlovid 5-Day in Stock Near You

Alternatives: A Quick Reference

When Paxlovid isn't the right fit or isn't available:

• Lagevrio (Molnupiravir): 800 mg (four 200 mg capsules) twice daily for 5 days. EUA. Fewer interactions. Lower efficacy (~30% relative risk reduction vs. Paxlovid's ~89%).
• Remdesivir (Veklury): 200 mg IV day 1, then 100 mg IV days 2-3. FDA-approved. Strong evidence. Requires infusion center access.
• Supportive care: For patients not eligible for antivirals — symptom management, monitoring, and clear return-to-care instructions.

For detailed comparisons: Alternatives to Paxlovid 5-Day.

Workflow Tips for Your Practice

• Build a Paxlovid pharmacy list: Identify 3-5 pharmacies in your area that reliably stock Paxlovid. Update this list quarterly or after surges.
• Create a prescribing checklist: Renal function → drug interaction screen → verify pharmacy stock → send Rx → share cost info → document
• Designate a point person: During surge periods, have one staff member responsible for tracking Paxlovid availability and assisting patients with fill issues
• Use Medfinder for Providers: Bookmark medfinder.com/providers for quick inventory checks
• Document interaction decisions: If you hold or adjust medications for the 5-day Paxlovid course, document the plan and set a reminder to resume/re-adjust after completion

Final Thoughts

Getting Paxlovid to patients who need it is a team effort. The prescribing decision is only the first step — ensuring your patient can find, afford, and fill the prescription within the treatment window is equally important.

By integrating real-time stock checking, proactive cost discussions, and clear backup plans into your workflow, your practice can significantly improve fill rates and patient outcomes. Start by bookmarking Medfinder for Providers and familiarizing your team with Pfizer's PAXCESS resources.

For the broader availability picture: Paxlovid 5-Day Shortage: What Providers Need to Know in 2026.