COVID-19 antiviral medication no longer available for free in Nova Scotia

A costly drug used to treat people who are at risk of becoming severely ill or dying after contracting COVID-19 is no longer available free of charge in Nova Scotia.

Paxlovid has been free for eligible patients in Nova Scotia since early 2022, but that has changed now that Ottawa is no longer paying to supply provinces with the antiviral.

Michelle Thompson, Nova Scotia's health minister, said Wednesday the antiviral has been added to the list of drugs covered by the province's Pharmacare programs.

That means those not enrolled in those programs will have to rely on their private health plans to cover the cost or they'll pay out of pocket if they're uninsured.

"There are a number of ways in which people access medications throughout this province," said Thompson. "And if we see that there is a gap, we will we react to that."

The list price for a five-day course of Paxlovid is $1,288, according to a bulletin for pharmacists from the province.

Paxlovid, made by Pfizer, was approved for use in Canada in 2022. It is used to treat people who are most at risk of a mild to moderate infection becoming serious or life-threatening.

Last month, the expert committee for the Canadian Agency for Drugs and Technologies in Health, the body providing advice for the country's publicly funded health-care systems, offered fresh guidance for how drug plans should cover the treatment. 

It suggested Paxlovid should only be reimbursed for patients who are severely or moderately immunosuppressed, or anyone with moderate immunodeficiencies.

Nova Scotians seeking Paxlovid have had to fill out a referral questionnaire, which lists factors used to determine who qualifies for the drug. They include:

• Being 65 or older.

• Being moderately or severely immunocompromised.

• Having one of 12 high-risk factors such as chronic kidney disease, diabetes or cancer.

Thompson said Wednesday only "a very small number of people are eligible for Paxlovid."

Those who will be able to get it through Pharmacare will have to be immunosuppressed either because of a medical condition, such as an organ transplant, or because they are being treated for cancer or other disease.

The Health Department said Nova Scotia received 21,600 standard dose treatment courses and 3,700 renal dose treatment courses of Paxlovid through the federally procured supply. It could not say how many doses remain from that supply, but the products are set to expire Friday.

Manitoba, Quebec and British Columbia are continuing to offer Paxlovid free of charge to anyone who meets their criteria.

In B.C., it's adults who are moderately to severely immunocompromised, and/or 60 years old with a chronic high-risk condition.

In Manitoba, it is available to anyone who is prescribed Paxlovid by their health-care provider.

According to the Quebec Health Department website, anyone eligible for the drug "will be able to receive Paxlovid treatment free of charge at the pharmacy of their choice."

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