Can a doctor call in a prescription without seeing you

Key Takeaways

• The FDA recently authorized pharmacists to prescribe Paxlovid to eligible patients who test positive for COVID-19. 
• To get a Paxlovid prescription from a pharmacist, patients must be able to connect the pharmacist to a physician to discuss their medical history, or present recent kidney and liver function tests to be sure the drug is safe for them. 
• Patients will also have to list and review all medications, including over-the-counter products they take, to be sure no dangerous interactions could occur.

Pharmacists can now prescribe the antiviral drug Paxlovid—an oral treatment for COVID-19—thanks to an expanded authorization from the Food and Drug Administration (FDA). Despite pushback from a few organizations, many infectious disease experts are applauding the move.

Previously, only physicians, nurse practitioners and physicians’ assistants were permitted to prescribe Paxlovid. Allowing pharmacists to prescribe any drug is very rare in the United States. Some states allow pharmacists to prescribe a narrow list of medications—and often only under a doctor’s supervision. 

Under the revised authorization, the FDA will allow state-licensed pharmacists to prescribe Paxlovid on their own to eligible patients. But there are a few caveats. Pharmacists must consult with a patient’s physician or review recent health records to ensure the patient isn’t taking any medications, supplements, or over-the-counter products that may interact with Paxlovid. The pharmacist must also be able to confirm a patient’s liver and kidneys are functioning properly.

“For Paxlovid to be effective, it is essential to start this medication as soon as possible, and looking to pharmacists to help get the drug to the patients that can benefit most makes good sense at every level,” Preeti Malani, MD, MS, MSJ, professor of medicine in the Division of Infectious Diseases and former chief health officer at the University of Michigan, told Verywell.

What Is Paxlovid?

Paxlovid is an oral antiviral pill authorized by the FDA in December 2021 to help prevent progression to severe disease, hospitalization, and death in people who test positive for COVID-19. Those at risk include older adults and people with certain chronic conditions including diabetes, obesity and heart disease, according to the Centers for Disease Control and Prevention (CDC). Paxlovid is taken three times a day for five days and must be started within five days of symptom onset.

Public health experts hope that allowing pharmacists to prescribe Paxlovid will increase its use, especially among those who don’t have a primary care provider. While the cost of the drug is free—the government is paying for it—a doctor’s appointment for a prescription may be costly. 

“This could have a modest effect toward increasing Paxlovid use,” Marcus Plescia, MD, MPH, chief medical officer of the Association of State and Territorial Health Officers, told Verywell. “Every little bit helps when it comes to getting this drug out there to people who can benefit from it.”

A Contentious Decision

After the FDA’s decision to allow pharmacists to prescribe Paxlovid, some medical organizations emphasized the importance of seeking a prescription from a primary care provider or physician. 

While noting the move has the potential to expand access to timely treatment, the Infectious Diseases Society of America (IDSA) issued a statement recommending prescriptions from primary care physicians whenever possible, deeming them the “most knowledgeable about a patient’s medical history and potential interactions.”

A statement from the American Medical Association (AMA) was more adamant about physician-ordered prescriptions: 

“While the majority of COVID-19 positive patients will benefit from Paxlovid, it is not for everyone and prescribing it requires knowledge of a patient’s medical history, as well as clinical monitoring for side effects and follow-up care to determine whether a patient is improving—requirements far beyond a pharmacist’s scope and training.”

The infectious disease specialists Verywell reached out to, however, expressed full support for the FDA’s decision to allow pharmacists to prescribe Paxlovid.

“As a COVID physician who works closely with pharmacists and relies heavily on their expertise, I fully support expanding privileges of pharmacists to prescribe Paxlovid,” Priya Nori, MD, an associate professor of medicine at the Albert Einstein College of Medicine and medical director of the Antimicrobial Stewardship at the Montefiore Health System, both in New York City, told Verywell. “No providers understand drug interactions like they do. Their comfort level may be higher than that of the average primary care, ER, or urgent care provider, groups who in my experience, remain hesitant to prescribe this drug.” 

Malani agrees, noting safety is top of mind for pharmacists. 

“The biggest clinical concern with Paxlovid is drug-drug interactions, and pharmacists are uniquely positioned to help make decisions about whether or not Paxlovid can safely be given to a particular patient by carefully reviewing their concurrent medications,” she said.

How to Get Paxlovid

Because Paxlovid must be taken within five days of symptoms starting, it’s important for patients to know how to access the drug. Pharmacists now have the authority to prescribe Paxlovid, but that doesn’t mean all pharmacies will immediately have the ability or resources to fill your prescription. Setting up the program may take time. 

A representative for CVS told Verywell it does not plan to expand Paxlovid prescribing capabilities to pharmacists outside of its Minute Clinic locations.

Walgreens says it is likely to start the program in underserved communities.

Here are other ways to get the drug if you are eligible:

• Call your doctor. If you test positive for COVID-19 and have a primary care physician who knows your recent medical history, start by contacting them to see if you’re a Paxlovid candidate. If your doctor thinks the drug is right for you, they can call a prescription into a local pharmacy and you can pick it up. Most physicians don’t charge for phone visits. If the pharmacy has a drive-through window for drug pickup, choose that option to limit who is exposed to you while you are positive for COVID-19. Some pharmacies also have same-day delivery. 
• Visit an urgent care clinic. If you test positive at home or have symptoms and want to be tested and evaluated, urgent care centers near you have health providers that can evaluate you and write a prescription. You’ll still need to go to the pharmacy for a prescription if the physician authorizes Paxlovid. If your insurance doesn’t cover the cost of the urgent care visit, expect to pay $100 to $150 to see the urgent care doctor. 
• Find a Test to Treat centers. In March, the Biden Administration launched “test to treat” centers in order to get Paxlovid to eligible people as quickly as possible. Use this locator to find a center near you, which could be a pharmacy, community health center, or other location. If you’ve taken a home test, bring it with you; otherwise, expect a free test at the center. The center may be able to dispense Paxlovid if they determine it’s right for you, or let you know the closest pharmacy that can. There is no charge for any portion.
• Visit a pharmacy clinic. Some pharmacies have store-based clinics with authorized staff that can test, evaluate, prescribe, and dispense Paxlovid. If the clinic is not affiliated with the Test to Treat program, you could be charged for the evaluation. If your insurance doesn’t cover it, fees can range from $50 to $150. 
• Telehealth visit. An efficient way to get Paxlovid is through a telehealth visit. A doctor can send an immediate prescription to a local pharmacy for you to pick up or have delivered. According to Michael Mina, MD, PhD, former associate professor of epidemiology, immunology, and infectious diseases at the Harvard T.H. Chan School of Public Health, it’s a good idea to have rapid tests on hand ahead of a telehealth visit. His testing company, eMed, offers online visits for Paxlovid evaluations. You must use the test provided by eMed (which can be delivered overnight), and a staff member must proctor your test by video. The test, proctoring, and evaluation costs $25. 

What This Means For You

While pharmacists writing prescriptions will improve Paxlovid access, it may take a while for this to actually start happening. If you are eligible for Paxlovid and hoping to get a prescription from your local pharmacist, make sure to call first to see if they’re actually offering it. 

If you do see a pharmacist about Paxlovid, you will need to give them a physician’s number they can call to ask about your health history, or provide recent liver and kidney function tests.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Fran Kritz
Fran Kritz is a freelance healthcare reporter with a focus on consumer health and health policy. She is a former staff writer for Forbes Magazine and U.S. News and World Report.

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