Covid Medicines Pathway

New COVID medicines pathway

This briefing explains the new process for patients who are at highest risk of becoming seriously ill from COVID-19, and how they will access antiviral medications.

The current Covid Medicines Delivery Unit (CMDU) delivered by GHC will cease from 27^th June 2023 and the process for patients to access these drugs has been re-commissioned to be provided by G-DOC (Covid Medicines Service), or directly via primary care or the patient’s specialist clinician. 

Pharmacy will start to see electronic FP10 prescriptions for these medications from next week (27^th June).

Which patients are high-risk?

Patients considered high-risk include those with cancer, blood conditions, kidney conditions, liver conditions or autoimmune disease. A list can be found on the government website: https://www.gov.uk/government/publications/higher-risk-patients-eligible-for-covid-19-treatments-independent-advisory-group-report-march-2023/defining-the-highest-risk-clinical-subgroups-upon-community-infection-with-sars-cov-2-when-considering-the-use-of-neutralising-monoclonal-antibodies  

Which medications are involved?

• Paxlovid
• Lagevrio

Both medications can be ordered from Alliance (free of charge) and should be started within 5 days of start of symptoms.

These medications have also been added to our Gloucestershire Pharmacy Emergency and Palliative Care Scheme Emergency_Care_Medicines_List_2023-2025, so pharmacies commissioned to provide this Local Service will always have these medications in stock. If you are unable to order and supply medication to a patient within the 5-day treatment window – please send electronic prescriptions back to the spine and refer your patient to one of the Emergency and Palliative Care stockholding pharmacies.  A list of these pharmacies can be found on the Community Pharmacy  Gloucestershire Website https://gloucestershire.communitypharmacy.org.uk/services/access-to-emergency-medicines-palliative-care/

How will I be paid?

You don’t need to do anything special. Process, dispense and claim anti-viral prescriptions the same as you would do normal FP10s. You will be paid a normal dispensing fee and £2.50 margin fee (this has been negotiated by Community Pharmacy England centrally)

How will patients get a prescription?

Patients who are high risk have been sent a letter from NHSE informing them that they are in a high-risk group and letting them know what to do. If they have covid symptoms they will do a covid test, and if they test positive for covid they can access antivirals either through their GP, their specialist at the hospital or through the Covid Medicines Service (G-DOC).

You may have patients phoning you if they are in and at-risk group, have symptoms and have tested positive. Pharmacies can ask patients to self-refer to the Covid Medicines Service (G-DOC) – number below.

Ideally, please assess the patient the following questions prior to giving them the self-referral number:

1. Check for red flag/sepsis symptoms. If you think patient is severely unwell refer urgently following usual processes (to patient’s GP, OOH using the healthcare professionals’ line or refer to A&E with a phone call first)
2. Ask date symptoms started – count as day 0 to calculate what day they are now – if more than 5 days then it is too late for the medication to have any effect – give them self-management advice
3. Ask when they tested positive for covid-19 – they must have tested positive – advise them where they can get a testing kit from if they do not have one
4. Are symptoms improving? – if yes then the treatment is not necessary – give them some self-management advice. You can give them the G-Doc Covid Medicines Service number to use if their symptoms worsen.
5. Explain the medication they may be prescribed will not treat the symptoms – it is a preventative medication to stop the virus multiplying that can usually be given up to 5 days from developing symptoms.
6. Any other questions will be answered by the clinician within the Covid Medicines Service (G-DOC).

If in any doubt – ask the patient to self-refer to the Covid Medicines Service.

Dedicated telephone number for the Covid Medicines Service – Tel: 01452 336291.