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NB now accepts rapid tests for COVID-19 drug prescriptions to increase access

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

Previously, a positive PCR (polymerase chain reaction) lab test result was required unless people work in a care home or live in an indigenous community during an outbreak.

Paxlovid is thought to reduce the risk of hospitalization or death for at-risk adults with mild to moderate symptoms when taken within five days of onset of symptoms.

“We knew that in certain regions it was difficult for some to get a PCR test and get those results within that five-day window,” said Dr. Yves Leger.

The province’s COVID-19 treatment website still advises that a PCR test will be required as of Wednesday afternoon, but Léger said the “fairly recent” change was shared with doctors and nurses who prescribe Paxlovid last week.

Some pharmacists called for the change last month, saying the drug is still too difficult to access in the province, although authorization has recently been expanded, giving all GPs the power to prescribe it and making it available in all pharmacies.

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

dr Yves Léger, deputy provincial health chief, said a “significant number” of people who were offered Paxlovid turned it down for a variety of reasons. (Pascal Raiche-Nogue/Radio-Canada)

To date, a total of 1,074 New Brunswick residents have been prescribed the drug, Health Department spokeswoman Michelled Guenard said. That’s up from 606 in late April and 323 in early April.

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

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

Paxlovid was approved for use in Canada in January.

When asked about the low percentage of treatment courses prescribed to date, Léger said: “A significant number of individuals, when approached and asked if they would like treatment, declined.

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

Monitoring the impact of changes, offer

When the province first received the drug, “it was in very short supply.

“As a result, we had to put in place a mechanism to do this fairly fairly across the province.

“We did that initially through…a centralized process, so at the time GPs couldn’t prescribe it themselves.” A team of pharmacists and consultants determined eligibility.

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

Prescriptions have increased since then, indicating improved access, he said.

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

The province initially wants to wait and monitor the impact of the other changes, he said.

“What we certainly don’t want is to open it up too quickly and then, you know, we’re quickly using up our supplies.”

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

At the moment, “there is no issue in terms of supply that would limit access at all,” he added.

The province has no information on when the next shipment of Paxlovid will arrive, the health ministry spokesman said.

No results statistics

Guenard did not respond to a request for information or statistics about the people who have been prescribed the drug to date or the success of their treatment.

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

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

People who are eligible for Paxlovid in New Brunswick include:

  • 18 years or older and moderately to severely immunocompromised
  • 80 years and older
  • 50 to 79 years old and not fully vaccinated
  • Are aged 50 to 79 and live in a long-term care facility or receive home care services
  • 50 to 79 years old and from or living in First Nations communities

For a full treatment, a patient must take 30 pills – 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 percent compared with a placebo in high-risk, non-hospitalized adults with COVID-19.

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

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