Paxlovid and Covid Care in England

Someone from the area will pop on and give you the scoop. I’ve heard it is difficult to get?

My doctor said he has no problem giving me a script before I travel. I had my yearly physical last week. I and grateful!

You won’t get Paxlovid easily here. It’s available only to people who are all ready registered with their doctor as being at particular risk. You can’t just go and buy it.

There are private General Practioner services available in big cities. I don’t know whether they would prescribe it. You would not be able to get it through an NHS doctor.

I find it unlikely that a pharmacy here would accept a script from a foreign country. We are quite strict on prescribing for various reasons and all pharmacists are employed by the NHS.

Simple response, take it with you. Then no concerns.

Just a note, of course you fill the script before you leave. Actually, my clinical doesn’t hand a script to anyone. It’s sent electronically to a pharmacy.

Many doctors will not give a prescription of Paxlovid without a diagnosis of Covid. You would need to have a discussion with your own doctor.

This is the NHS advice about COVID care in England

https://www.nhs.uk/conditions/covid-19/

Essentially unless you are at the highest risk of becoming seriously ill, you stay at home, take paracetamol, and wait to get better. If you become seriously ill the doctors will decide the best course of action.

Agree with Claudia! If at all possible (and it should be) have your doctor call it in and take it with you.

This was just in the LA Times recently, an article about how doctors have been reluctant to prescribe Pax. And then people wrote in saying when they went to the pharmacy to pick it up, the price was $1,000. So beware.

The problem is that whether Paxlovid is right for you depends on a number of things. When my 88 year old mother got Covid in late December, I contacted her PCP about starting Paxlovid. I had to have a video interview where we discussed whether she could tolerate the medication due to her kidney function, and which medications she needed to stop while she was on Paxlovid, and what things to starting doing during that period. They did prescribe it in the end since the pros outweighed the cons. So if you hope to take some with you, make sure you have a detailed conversation with your doctor about the circumstances for using it.

the summary above is pretty much what we'd expect here.

There have been many reports of people being initially helped by it but then getting what is called rebound covid which is usually worse than the initial bout.

Doctors here are very reluctant to prescribe it for routine care - you need to be clinically very unwell and not have any issues which mitigate against it, and be monitored closely. You might be in hospital. If so the nurses, Sisters and doctors will take good care of you.

Really interesting, the cultural differences.

Yes different health cares systems provide different care. There are still 1500 or so people a week dying from COVID in the US, and likely a proportionate number in the UK. The taxpayer-funded NHS in the UK likely preferring to spend money on the people there who more likely to benefit from the drugs. The US for-profit doctors willing to prescribe "just-in-case" for customers might not get approval from Medicare & insurance companies for patients not identified in the (coding) system as meeting the criteria for benefits. Dont get me wrong, I'd like to get some just-in-case too, but not if I can't get someone else to cover the high cost and have to pay >$1000 out of pocket.

I was told by an English MD working in Scotland, that prescription meds are covered in emergencies in Scotland, but NOT in England. Emergency medical services ARE covered all over the UK (not sure about the Channel Islands or Isle of Man). I have partaken of emergency medical services in Scotland, and would recommend feeling ill there, any day, if you have a choice in the matter.

Covid testing was available from pharmacies, for not much money, but free from an MD. I was negative, and had something else. Highly recommend Paracetemol if painkillers needed - basically acetaminophen and caffeine. It is the go-to for the Brits.

Not just emergency prescriptions, but all prescriptions (unless issued in England) are free in Scotland, under devolved government. In England they are free to the over 60's.

Really interesting, the cultural differences. It's for-profit medicine.

The French system is similar to the British. My French doctor said he wouldn't have prescribed Paxlovid for my Covid-positive runny nose while I was visiting the States, the way the US video nurse practioner did. The French system lets the immune system do its work and then steps in if needed. My doctor was concerned about the possible side effects of this medication, not just rebound. But my daughter-in-law got the appointment for me, so I dutifully swollowed the pills. Even my son was given a prescription, just in case, because he had spent the day with me after I got off the plane from France.

For-profit medicine. Sorry I exposed my kidneys to a potential beating.

Last fall, my doc said she wouldn't prescribe Paxlovid for my trip, just in case. No worries, we tested positive shortly before our trip with almost indistinguishable symptoms. Got that out of the way!

And I can testify that Paxlovid rebound is real, my second bout immediately followed the first and was quite bad

In the US you can go online and get a Rx for Paxlovid.

I was extremely sick with Covid on Christmas Eve, Dec 24 (a Saturday) 2022. i waited all day for my doctor to call me, but got no return call. My only option that evening was to get a Rx online before the last pharmacy in my area closed for Christmas.

https://www.yalemedicine.org/news/13-things-to-know-paxlovid-covid-19#

You would be unlikely to get Paxlovid from a UK doctor for ‘mild to moderate’ Covid as it’s only licensed for adults with COVID-19 in the group of people at high risk of severe disease, including hospitalisation and death. Unless you fall into that group or are ill in hospital with it you wouldn’t qualify for the NHS funding it.

I think that is technically also the case now in the US.

Also for those of you filling the prescription that you don’t need your insurance company might have a couple of questions too. Don’t be surprised if they realize there was never a corresponding diagnosis and ask you to pay the entire amount and you might want to look what that is. I’ve spent a long time in healthcare - dealing with the insurance company side. Heck, I just had to have a review in my mother’s account. She’s in hospice and she hasn’t been to a doctor to have diagnosis updated in two years. The nurse practitioner and I won that, but it could’ve easily gone the other way and we would’ve been OK with it.

My insurance paid with no question.

The amount that Paxlovid is covered is changing. It is shifting or has been shifted from government funding to commercial. So the cost can be zero or expensive depending. So one person's experience will not be the same as anothers. Best to talk with your doctor and see if it is appropriate to get a rx to take with you and then check with your insurance regarding coverage. Each person's health and circumstances are unique.

https://www.hhs.gov/about/news/2023/10/13/hhs-and-pfizer-reach-agreement-to-increase-patient-access-to-paxlovid.html

My insurance paid with no questions

Or did it? Seriously, these "clawbacks" for unneeded prescriptions are NOT real time. It could be months or even a year before you get the bad news.

As i said, i got the Rx filled on 12/24/22.
Never heard a word from my insurance about it.

Or did it? Seriously, these "clawbacks" for unneeded prescriptions are NOT real time. It could be months or even a year before you get the bad news.

Carol, can you send me the link where you are reading about clawbacks? I hadn't heard that once claims are processed and paid that the insurance company is coming back months later to take back the payment.

Nope I can't send links because the "links" would have protected health information in them. I work in healthcare administration and deal a lot with insurance denials..... Those are often after the fact due to audits.

Understood. Thanks Carol.