Pharmacists Prescribing Paxlovid and PBMs


Here are updates on two developing issues at the federal and state levels:

FDA Includes Pharmacists in Revised Paxlovid Prescribing Authority
Last week, after months of advocacy from AmerisourceBergen/Good Neighbor Pharmacy and pharmacy organizations such as NCPA, APhA and NACDS, the FDA revised the EUA for Paxlovid, authorizing state-licensed pharmacists to prescribe Paxlovid to eligible patients, with certain limitations the FDA believes are necessary to ensure appropriate patient assessment and prescribing.

AmerisourceBergen makes it clear in Jenni Zilka’s press statement that while this is a positive development, more needs to be done to strengthen the ability of pharmacies and pharmacists to provide valuable patient care. And while the FDA recognizes “the important role pharmacists have played and continue to play in combatting this pandemic,” and the need to involve pharmacists as they can provide this valuable care in the critical five days after symptoms begin (See the FDA press release, quoting Patrizia Cavazzoni, director for the FDA’s Center for Drug Evaluation and Research), the restrictions are concerning. AB will continue to advocate with stakeholders such as NACDS and NCPA over remaining questions regarding reimbursement and the standards by which pharmacists will be held to in order to be able to prescribe.

Florida is Re-evaluating State PBM Contracts
Florida Gov. Ron DeSantis (R) announced plans to sign an executive order that aims to examine PBMs and provide drug cost transparency. Under the order, state agencies will be directed to re-evaluate their contracts with PBMs to ensure “that costs to the state of Florida are justified.” The Agency for Health Care Administration (AHCA), which oversees the state’s Medicaid program, and the Department of Management Services will audit the PBMs they work with to determine whether cost-saving measures are in place. The announcement comes just weeks after AHCA issued a “request for information” on ways to improve the Medicaid managed care program, including ways to protect patient access to community-pharmacist services.

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