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COVID-19 treatment


Oral therapy

Updated Jan. 26, 2022

The Food and Drug Administration (FDA) has granted Emergency Use Authorizations (EUA) for two oral antiviral medications, Paxlovid (nirmatrelvir/ritonavir) and Molnupiravir, for the treatment of mild to moderate COVID-19.

Criteria for Paxlovid eligibility include:
  • A positive COVID-19 viral test result.
  • 12 years of age or older weighing more than 88 pounds.
  • Be within five days of symptom onset.
  • Meet high-risk criteria (high risk for progression to severe COVID-19, including hospitalization and death).
Criteria for Molnupiravir eligibility include:
  • A positive COVID-19 viral test result.
  • 18 years of age or older
  • Meet high-risk criteria (high risk for progression to severe COVID-19, including hospitalization and death).
  • Be within five days of symptom onset.
  • Alternative COVID-19 treatment options authorized by FDA are not accessible or clinically appropriate
The federal government is allocating the oral medication to the state health departments. For the next few weeks, there will be:
  • A limited amount of medication available.
  • A limited number of pharmacies in Arizona who will receive the antiviral medication.
Your medical provider will determine if it is appropriate for you to be treated with COVID-19 antiviral medication based on criteria that identifies the highest-risk patients. Providers will issue prescriptions and information about participating pharmacies.

These meds do not take the place of vaccination, masks and other protective measures to prevent the transmission of COVID-19.

At this time, the Arizona Department of Health Services (ADHS) recommends that healthcare providers prioritize the use of Paxlovid and Molnupiravir ollows:
  • Patients 70 years of age or older
  • AND with severe underlying health conditions (i.e., end stage renal disease, end stage cardiac disease, severe liver disease or those with severe blood disorders)
  • OR who are immunocompromised (i.e., AIDS, cancer and/or transplant patients)
Find more information on antivirals and current prioritization guidance from the Arizona Department of Health Services.

Healthcare Providers can contact the Arizona Poison Control Systems COVID-19 Hotline (844-542-8201) to find a distribution site close to them.

UPDATED DEC. 23: What is known about the oral pills to treat COVID-19?

On December 22 and 23, 2021, the FDA issued an Emergency Use Authorization (EUA) for Pfizer’s Paxlovid, and Merck’s molnupiravir. Both are prescription-only antiviral pill that target different aspects of the COVID-19 virus' ability to make additional copies of itself and infect new cells, thus reducing the risk of serious disease. 

Paxlovid is for use in people 12 and older who have tested positive and are at high risk for severe illness or hospitalization from COVID-19; it is taken twice a day for five days in combination with another antiviral drug called ritonavir. Treatment should start as soon as possible after diagnosis and within five days of the start of symptoms.

In clinical studies, Pfizer reported Paxlovid reduced the risk of hospitalization or death by 89% when taken within three days of first symptoms of illness, and reduced the risk of hospitalization and death by 88% when taken within five days. Researchers anticipate it will be effective against infection with the omicron variant, although this is not yet fully known. The FDA offers more information in fact sheets for patients and for healthcare providers.

Molnupiravir by Merck is for use in people 18 and older who have tested positive and are at high risk for severe illness or hospitalization from COVID-19. Treatment should start as soon as possible after a COVID-19 diagnosis and within five days of the start of symptoms. Some studies indicated it may reduce the risk of hospitalization by 30%. The FDA offers more information about molnupiravir in fact sheets for patients and healthcare providers.

Supplies of these medications may be limited initially, while the federal and state governments determine distribution. For more information about either of these treatments, please ask your healthcare provider.


Monoclonal antibodies (mAB)

For questions about whether you can or should get mAB treatment, call your doctor or health care provider.

Antibodies are proteins that people’s bodies make to fight viruses, including the virus that causes COVID-19. Monoclonal antibodies (mAB) are laboratory-made proteins that fight viruses that mimic those made by the immune system.

Monoclonal antibody treatment may be a good option for people who meet certain criteria, to help strengthen their immune system, and fight off COVID-19.

An important note about mAB treatment

Monoclonal antibody (mAB) treatment is authorized by the FDA under Emergency Use Authorization (EUA) while clinical studies continue to evaluate its usefulness and safety.
 
The FDA issued EUAs for three separate mAB products to prevent patients at high risk for severe illness from COVID-19 disease from getting very sick and needing to be hospitalized.
 
REGEN-COV (casirivimab administered together with imdevimab) is for the treatment of those 12 years and older who have tested positive for COVID-19, have mild to moderate symptoms, and are at high risk for getting severe COVID-19. It can be given for post exposure prevention of COVID-19 for those at high risk for getting severe illness who also meet certain strict criteria.
 
Bamlanivimab administered together with etesevimab is authorized for the treatment of newborns to adults who have tested positive for COVID-19, have mild to moderate symptoms, and are at high risk for getting severe COVID-19. It may also be given for post-exposure prevention of COVID-19 for those at high risk for getting severe illness who also meet certain strict criteria.
 
Sotrovimab is for those 12 and older who test positive for COVID-19 and are at high risk for severe disease progression. Treatment with mAB is not a substitute for vaccination.


COVID-19 mAB information for clinicians is available on the Health and Other Partners page.

Frequently Asked Questions

UPDATED DEC. 10: Who can get mAB treatment in Pima County?

Monoclonal antibody (mAB) treatment with REGEN-COV may be used in people with mild to moderate COVID-19 who:

Monoclonal antibody (mAB) treatment is for use in people with mild to moderate COVID-19 who:
  • Test positive for SARS-CoV-2. 
  • Are within 10 days of the start of their symptoms. 
  • Are at high risk of getting very sick from COVID-19 or of needing to be admitted to a hospital because of COVID-19.
REGEN-COV (casirivimab administered together with imdevimab) and bamlanivimab administered together with etesevimab are also allowed for use as post-exposure prevention of illness in people who:
  • Are not fully vaccinated or who are not expected to mount an adequate immune response to complete COVID-19 vaccination (such as people with immunocompromising conditions, including those taking immunosuppressive medications) and
  • Have been exposed in close contact to an individual infected with SARS-CoV-2 or
  • Who are at high risk of exposure to a person infected with SARS-CoV-2 because of occurrence of SARS-CoV-2 infection in other people in the same institutional setting (such as a nursing home or a prison).
For questions about whether you can or should get mAB treatment, call your doctor or health care provider. If you do not have a doctor or health care provider, please call the Pima County Department of Health (PCHD) at (520) 724-7770.

UPDATED SEPT. 30: Is mAB effective against COVID-19?

Clinical trials for mAB therapy showed COVID-19 patients who received this treatment ended up in the hospital and emergency room less often. Evidence suggests that they are effective against several circulating COVID-19 variants, including Delta. See more information in the latest treatment guidelines from the National Institutes of Health.

UPDATED SEPT. 30: What are side effects of mAB for COVID-19?

Clinical studies are ongoing to evaluate the usefulness and safety of mAB treatment. Because the three products REGEN-COV (casirivimab given with imdevimab), bamlanivimab given with etesevimab, and sotrovimab are investigational, they are still being studied and it is possible that not all risks and side effects are known yet.

The side effects of getting any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the infusion site. Allergic reactions and a worsening of COVID-19 symptoms are also possible. For the possible side effects from each product/combination, see the FDA’s fact sheets for patients, parents and caregivers for REGEN-COV, bamlanivimab given with etesevimab, and sotrovimab

Because these are antibody treatments, it is possible that it could get in the way of your body’s own ability to fight off a future infection with SARS-CoV-2 (the virus that causes COVID-19), or it could reduce your body’s immune response to a vaccine for COVID-19. Studies have not been done to understand these possible risks. Talk to your doctor or health care provider if you have any questions about the risks.

How much does mAB for COVID-19 cost?

Patients should work with their insurance provider and the hospital providing the treatment. Pima County is working to ensure that any location that gives antibody treatments is considered in network and covered by insurance. Information on Medicare coverage for mAB therapy can be found at CMS: Coverage of Monoclonal Antibody Products to Treat COVID-19.

UPDATED SEPT. 30: How do I get mAB for COVID-19?

Talk to your doctor or other health care provider about whether you should get antibody treatment and where you can get it. A health care provider must prescribe mAB infusions. If you do not have a doctor or health care provider, please call the Pima County Health Department at 520-724-7770.

How do patients in skilled nursing facilities get mAB for COVID-19?

Staff at the facility can contact the Pima County Health Department at congregatecare@pima.gov and staff will assist them in getting mAB treatment for their patients.

UPDATED SEPT. 30: How do I take mAB for COVID-19?

Monoclonal antibodies may only be administered in settings in which health care providers have immediate access to medications to treat a severe infusion or hypersensitivity reactions, such as anaphylaxis, and the ability to activate the emergency medical system if needed.

Depending upon the particular product used, and the medical setting in which it is given, antibody treatment is typically given to you into a vein (intravenously), but it may also be given as an injection under the skin (subcutaneously). When the products are used for prevention of disease after exposure, repeat doses may be given every several weeks.

UPDATED DEC. 22: Can I get the COVID-19 vaccine after having received mABs?

If you received antibody therapy to treat a COVID-19 infection, the CDC recommends that you wait 90 days before getting vaccinated. If you received antibody therapy to prevent a COVID-19 infection after having been exposed (post-exposure prophylaxis) you should wait 30 days before getting vaccinated.
 
The waiting periods between mAB therapy and COVID-19 vaccination are to help avoid any potential interference between the immune responses generated by the mAB therapy and those generated by the vaccine. 

Non-COVID-19-related antibody therapies (such as intravenous or subcutaneous immunoglobulins, or RhoGAM) do not need to wait on COVID-19 vaccination and may get vaccinated according to their healthcare provider’s guidance.

DEC. 14: Are there any mABs for prevention of COVID-19?

A monoclonal antibody (mAB) product for the prevention of COVID-19 received FDA Emergency Use Authorization (EUA) on December 8, 2021. The product, called Evusheld, consists of two mABs (tixagevimab and cilgavimab) given as two injections into the muscle. It cannot treat COVID-19, but can only help to prevent it.
 
It may only be given to people 12 and older not infected with COVID-19 and who have not been in recent close contact with someone infected with the virus, and who either:
  • Are moderately to severely immunocompromised (have a weakened immune system) from a condition or medications and may not develop sufficient protection from COVID-19 vaccination.
OR
  • Have a history of severe adverse reaction (such as a severe allergic reaction) to a COVID-19 vaccine or ingredient(s) in the vaccine, so that the vaccine is not recommended.
The most common side effects reported in studies were headache, fatigue and cough. Because Evusheld is investigational, all of the possible side effects are not known. Learn more about Evusheld from the Fact Sheet for Patients, Parents and Caregivers, and the manufacturer’s website. Please talk to your healthcare provider about any questions you may have about this product.

Getting mAB for COVID-19 in Pima County

Because it is given as an IV, mAB treatment for COVID-19 is only available in certain clinical settings. This list may change.

Tucson Medical Center

Not participating

Amber Specialty Pharmacy

  • Providing home-infusion for high-risk patients. Patients interested in receiving monoclonal antibody treatment for COVID-19 need to contact a licensed practitioner for a prescription. 
  • Your healthcare provider will determine a) if you are eligible to receive this treatment and b) which therapy is appropriate for you. This form should be printed, completed by your doctor, and faxed to Amber Specialty Pharmacy.
  • Contact: www.amberpharmacy.com or 888-370-1724.
  • No cost for treatment but administration costs may occur.

Arizona Liver Health

1601 N. Swan Rd, Tucson, AZ 85712
Monday through Friday, 8 a.m. to 5 p.m.
Physician referral or self-referral: 520-445-4000

  • To qualify, you must have tested positive and be symptomatic, and you will need to provide a positive test result. You may use a result from a self-test kit. Take a picture of the positive result or bring the kit with you to the clinic.
  • The cost is billed to insurance if you have insurance. If you do not have insurance, you must self-pay.
  • A pediatric trial is in process for those under the age of 18 years at no cost.

Banner Health

3950 S. Country Club Rd., Tucson, AZ 85714
Customer Care Center: 833-252-5535

Banner Health is accepting referrals for monoclonal antibody infusion therapy. Physicians: If you have a patient who may be eligible for treatment, you can refer a patient to Banner's infusion center. Click here to learn more about the referral process. Banner antibody infusion center treats patients at the Abrams Public Health Center facility by appointment only.
 
Banner Health is no longer providing casirivimab/imdevimab and bamlanivimab/etesivimab based on the prevalence of the omicron variant, instead, sotrovimab will be administered based on Banner Health’s COVID monoclonal antibody guidance and sotrovimab availability. 
 
Patients: If you think you meet the criteria for mAB for COVID-19, please contact your primary doctor or schedule an appointment with a Banner Urgent Care telehealth provider for a referral to a Banner Health infusion center. For more information, including about eligibility, visit Banner's website.
 
You can also schedule an appointment with Banner Urgent Care to be tested for COVID-19 and be evaluated for this treatment. 

Carondelet St. Raphael’s Emergency Center

Not participating

Northwest Hospital  

Not participating

Oro Valley Hospital 

Not participating

St.  Joseph’s

Not participating

St.  Mary’s

Not participating

Santa Cruz Valley Regional Hospital

4455 S. I-19 Frontage Rd., Green Valley, AZ 85614
mABs are available. Please contact this facility for further information to confirm availability of mAB: 520-393-4700.

Sells

Not participating

VA

The V.A. hospital will coordinate mAB infusions for eligible patients, as appropriate.  If you are a Veteran and receive your healthcare from the V.A. in Tucson, please contact your primary care office if you have tested positive for COVID-19. 

More information on mAB & COVID-19
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Ste. 100
Tucson, AZ 85714

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