NEW 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 27th 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 (27th 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:
- 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)
- 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
- 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
- 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.
- 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.
- 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.
