NB Now Accepting Rapid Tests for Prescribing COVID-19 Medications to Improve Access

ByDonald L. Leech

May 18, 2022

New Brunswick is now accepting a positive COVID-19 rapid test result for a prescription for the free antiviral treatment Paxlovid to help increase access, the province’s acting deputy chief medical officer of health said.

Until now, a positive PCR (polymerase chain reaction) lab test result was required unless people worked in a nursing home during an outbreak or lived in an Indigenous community.

Paxlovid is designed to reduce the risk of hospitalization or death in vulnerable adults with mild to moderate symptoms if taken within five days of the onset of symptoms.

“We knew that in some areas the ability to get a PCR test and get those results in that five-day window was difficult for some,” said Dr. Yves Léger.

The province’s COVID-19 treatments website still says a PCR test is required, Wednesday afternoon, but Leger said the “fairly recent” change was shared with doctors and nurse practitioners last week. , who prescribe Paxlovid.

Some pharmacists called for the change last month, saying the drug was still too difficult to access in the province, despite the recent expansion of eligibility, with all primary caregivers having the authority to prescribe it and being available in all pharmacies.

New Brunswick was the only Atlantic province not to accept rapid tests.

Dr. Yves Léger, the province’s acting deputy chief medical officer, said a “significant number” of people who were offered Paxlovid turned it down for a variety of reasons. (Pascal Raiche-Nogue/Radio-Canada)

A total of 1,074 New Brunswickers have been prescribed the drug to date, said Department of Health spokeswoman Michelled Guenard. That’s up from 606 at the end of April and 323 at the start of April.

The province has 6,226 treatment courses in stock, she said.

By comparison, in PEI, more than 1,200 courses of treatment have been prescribed as of April 25.

Paxlovid was approved for use in Canada in January.

Asked about the low percentage of cures prescribed so far, Leger said that “a significant number of individuals, when approached and asked if they wanted to seek treatment, refused it.

“They didn’t want to seek treatment, either because they felt their symptoms weren’t serious or because they were already starting to get better.”

Tracking the impact of changes, procurement

Additionally, when the province first received the drug, “the supply was very limited.

“Because of that, we needed to put in place a mechanism to roll this out fairly evenly across the province.

“We did it initially through … a centralized process, so primary care providers couldn’t prescribe it themselves at that time.” A team of pharmacists and specialist consultants determined who was qualified.

As supply grew, the province moved to “more community-based access,” allowing primary care providers to prescribe it.

The number of prescriptions has increased since then, indicating better access, he said.

Although some provinces, such as Quebec and Alberta, have extended prescribing privileges to pharmacists to further increase access, Leger said New Brunswick has no immediate plans to follow suit, but does didn’t rule it out.

The province wants to wait and monitor the impacts of other changes first, he said.

“What we definitely don’t want to do is open it too quickly and then, you know, we quickly run out of stock.”

“But we’ll definitely look at that, you know, depending on whether our supply numbers continue to be good.”

At this time, “there are no supply issues that would restrict access,” he added.

The province has no information on when its next delivery of Paxlovid will arrive, the health ministry spokesperson said.

No statistics on the results

Guenard did not respond to a request for information or statistics on who has been prescribed the drug so far, or how successful their treatment has been.

“The best defense against Omicron is vaccination and we urge everyone to ensure they receive their booster dose as soon as possible,” she said in an emailed statement.

“Paxlovid has significant drug interactions with commonly prescribed medications and is not for everyone.”

People eligible for Paxlovid in New Brunswick include those:

  • 18 years or older and moderately to severely immunocompromised
  • 80 years and over
  • 50 to 79 years old and not fully vaccinated
  • 50 to 79 years old and living in a CHSLD or receiving home services
  • 50 to 79 years old and from or living in First Nations communities

Full treatment requires a patient to take 30 tablets – two nirmatrelvir and one ritonavir taken together twice a day for five days.

In November, Pfizer reported that Paxlovid reduced the risk of hospitalization or death by 89% compared to a placebo in non-hospitalized high-risk adults with COVID-19.

To get a prescription for Paxlovid, people who test positive for COVID should contact their primary care provider. People who do not have a primary care provider or do not have timely access to their provider should call TeleCare 811 or visit visit NB for an online consultation with a nurse practitioner or doctor.