COVID-19 Oral Antivirals

In Dec. 2021, the Food and Drug Administration (FDA) began issuing Emergency Use Authorizations (EUA) for oral COVID-19 antiviral therapies. ;HHSC allows Molnupiravir and Paxolvid at no cost to clients enrolled in Medicaid, CHIP, and the CSHCN Services Program.

COVID-19 oral antivirals must be approved or have a EUA by the FDA, and healthcare providers must order per criteria specified by the FDA approval or authorization.

The EUA requires Paxlovid and Molnupiravir oral antivirals to be accessed by prescription only. HHSC does not require prior authorization for these medications and is not authorized by the FDA to prevent COVID-19.

Paxlovid treats mild-to-moderate COVID-19 in adults and children 12 years and older at high risk for progression to severe COVID-19. Healthcare providers should initiate Paxlovid after diagnosis of COVID-19 within five days of symptom onset.

Molnupiravir treats mild-to-moderate COVID-19 in adults 18 years and older. The medication is indicated to treat individuals with a confirmed diagnosis of COVID-19 who are at high risk for progression-to-severe COVID-19 and for whom alternative treatment options authorized by the FDA are not accessible or clinically appropriate. Healthcare providers should initiate Molnupiravir after diagnosis of COVID-19 and within five days of symptom onset.

Refer to the Texas Department of State Health Services Information for Hospitals and Healthcare Professionals for more information about Paxlovid and Molnupiravir.

The medication has no ingredient cost because the federal government has purchased treatment courses. DSHS will distribute the medicines to pharmacies. Pharmacies should submit a dispensing fee of no less than $8.08 at a minimum because of no ingredient cost.