Get the Latest Guidance
COVID-19 Therapeutics in Virginia
COVID-19 cases can result in serious illness, hospitalizations and deaths. Treatments are available for individuals at risk for severe disease progression. Please use this page to get the latest guidance on COVID-19 Therapeutics in Virginia. Therapeutics administration is best practice. These medications are available in ample supply and should be prescribed for eligible patients.
Important Updates
New and Notable: COVID-19 Therapeutics Announcements from ASPR
Subscribe to the Healthcare Professionals Newsletter: here.
Previous Healthcare Professionals Newsletters: here.
Summary of COVID-19 Therapeutics
Summary Table of Food and Drug Administration Authorized Treatments for High-Risk Patients
| Type | Classification | Use | How is it given? | When is it given? | |
| Treatment | Remdesivir Veklury) | IV Antiviral | For treatment of COVID-19 (inpatient or outpatient) | By IV infusion | Within 7 days of symptoms starting |
| Nirmatrelvir / ritonavir (Paxlovid) | Oral Antiviral | For treatment of mild-moderate COVID-19 | By oral tablet | Within 5 days of symptoms starting | |
| Molnupiravir (Lagevrio) |
Summary Table of Key Highlights for Preferred Therapeutic Agents
| Preference of Therapeutics | Therapeutic Agent | Key Highlights |
| First line | Paxlovid Remdesivir | • Paxlovid has many drug-drug interactions; not all COVID-19 positive patients can safely take this medication • Remdesivir is cost prohibitive • Remdesivir must be administered via an IV infusion over 3 days, which may be burdensome • Remdesivir supply is not controlled by the state; providers may purchase via the private sector |
| COVID-19 Therapeutic Shelf-Life Extensions | ||||
| Several COVID-19 Therapeutic products may have initial expiration dates approaching, however, many have received extensions. Please check the ASPR searchable expiry database before removing any products from the proper storage conditions by checking the links below for specific expiry information. Please maintain all monoclonal antibodies under proper refrigerated temperatures, even if they are not currently authorized for use. Proper storage is needed in the event they may be authorized again in the future for use against new strains of SARS-COV2. | ||||
| Product | Date | Shelf-Life Extension | Website | |
| Currently Distributed | Paxlovid | January 18, 2023 | from 18 months to 24 months | Shelf Life Extension for Certain Lots of Paxlovid | Important Updates | HHS/ASPR |
| Lagevrio | June 14, 2023 | from 30 months to 36 months | Shelf-Life Extension of Lagevrio | Important Updates | HHS/ASPR | |
| Product | Date | Shelf Life Extension | Website | |
| Legacy | Evusheld | December 5, 2022 | from 18 months to 30 months | Shelf-Life Extension of Evusheld | HHS/ASPR |
| Bebtelovimab | October 28, 2022 | from 18 months to 24 months | Shelf-Life Extension of Bebtelovimab Authorized | Important Update | HHS/ASPR | |
| Bamlanivimav/ Etesevimab | May 4, 2022 | from 18 months to 24 month (No additional shelf life extension is possible for etesevimab*) | Shelf-Life Extension for Bamlanivimab | Important Update | HHS/ASPR | |
| Regen-Cov | June 27, 2022 | from 24 months to 30 months | Shelf-Life Extension for REGEN-COV | Important Update | HHS/ASPR | |
| Sotrovimab | February 15, 2023 | from 24 months to 30 months | Shelf-Life Extension of Sotrovimab | Important Update | HHS/ASPR | |
| **Product can be returned for destruction as a bam/ete patient course using expired ete with matching bam vial of earliest expiration date (patient course = 2 vials Etesevimab, 1 vial Bamlanivimab) |
| USG Supplied COVID-19 Therapeutic Product Return Guidelines | |||
| All therapeutic products are property of the United States Government (USG) and must be used in accordance with EUA guidance. Sites cannot donate products to entities outside the U.S. or for use outside the U.S. Any returned product will be destroyed, as product integrity cannot be verified. Non expired product should not be destroyed. No returns of product currently in distribution by the USG. If you seek to redistribute currently distributed products please fill out VDH's request to Redistribute Excess Therapeutics. Expiration dates are often extended, check ASPR searchable expiry database for updates or notices on potential pending updates on any expired or nearly expired product before returning. Upon these considerations, if undamaged product needs to be returned, follow the below instructions: | |||
| Product | Return Information | Website | |
| Currently Distributed | Paxlovid | No Product Return Available | |
| Lagevrio | |||
| Product | Return Information | Website | |
| Legacy | Evusheld | No information at this time | |
| Bebtelovimab | |||
| Bamlanivimab/ Estesvimab* | Expired Product Returns please see Lilly Return Goods Procedure 1-800-505-9291 (Qualanex) customerservice@qualanex.com | https://www.trade.lilly.com/ | |
| Regen-cov | Please call 1-844-734-6643 | ||
| Sotrovimab | https://www.gsk-ecs.com/gskstorefront/gskEcs/en_US/USD/ | ||
| *Product can be returned for destruction as a bam/ete patient course using expired ete with matching bam vial of earliest expiration date (patient course = 2 vials Etesevimab, 1 vial Bamlanivimab) |
Billing Information
Patients who are underinsured or uninsured can visit the VDH website or call their local health department to locate a nearby Federally Qualified Health Center (FQHC) or Free Clinic for access to COVID-19 treatment.
Oral Antivirals
CMS has issued guidance to inform Part D sponsors of permissible flexibilities related to oral antiviral drug(s).
Monoclonal Antibodies
CMS has issued guidance to inform coverage and reimbursement of monoclonal antibodies. Please see the flyer and CMS website for reimbursement information below:
Provider Enrollment and Job Aids
Provider Resources
Additional Resources:
- VDH Variant and Therapeutics With variants continuing to evolve and the potential impacts on available therapeutics, VDH continues to update this resource to help providers stay up to date on what COVID-19 drugs are expected to be effective. (PDF) (3pp, 327kb)
- VDH: COVID-19 General FAQs
- HHS: Therapeutics Expiry Searchable Database
- COVID-19 Outpatient Therapeutic Treatment Algorithm
- FDA: Paxlovid Prescribing Checklist
- VDH: Paxlovid Prescribing Checklist-Pharmacists
- FDA: Paxlovid Information Sheet
- Liverpool Interaction Checker
- FDA: Molnupiravir Prescribing Checklist
- FDA: Lagevrio Information Sheet
- VDH: Guidance on Expiring & Expired Therapeutics
- VDH: COVID-19 Therapeutics Overview Presentation
- VDH: COVID 19 Therapeutics Overview HPOP and Redistribution Process
- VDH: COVID-19 Therapuetics Pharmacists Prescribing Paxlovid Informational Webinar
- HHS: ASPR Test to Treat Fact Sheet
- CDC: Clinical Care Guidance for Healthcare Professionals about Coronavirus
- CDC: Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19
- NIH: COVID-19 Treatment Guidelines
- IDSA: Guidelines on the Treatment and Management of Patients with COVID-19
- IDSA: Therapeutics & Interventions
- AAP: Outpatient COVID-19 Management Strategies in Children and Adolescents
- COVID-19 Therapeutics Resource Document for UniteUs
Patient Resources
- VDH: Treatments Webpage
- CDC: How to Protect Yourself and Others
- CDC: COVID-19 Plan [English] [Spanish]
- VDH: COVID-19 Therapeutics Comparison Chart [English] [Spanish]
- VDH: Paxlovid Treatment Fact Sheet [English] [Spanish] [Amharic] [Arabic] [Chinese] [Dari] [Korean] [Pashto] [Tagalog] [Urdu] [Vietnamese]
- VDH: Lagevrio (Molnupiravir) Treatment Fact Sheet [English] [Spanish] [Amharic] [Arabic] [Chinese] [Dari] [Korean] [Pashto] [Tagalog] [Urdu] [Vietnamese]
- CDC: Treatments Your Healthcare Provider Might Recommend if You Are Sick
Page last updated September 8, 2023
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