We are seeing an increase of Omicron prevalence this week with estimated variant predominance estimated at 100% of all cases statewide. This has been confirmed in both wastewater surveillance as well as genomic surveillance systems. Please be aware, that the only monoclonal antibody product authorized for treatment with data showing effectiveness against Omicron is Sotrovimab. Sotrovimab remains in short supply but we advise you to stratify among patients to select those most at risk and use the most effective antiviral available to you based on the risk of the patient being evaluated. Both oral antivirals are expected to retain efficacy against Omicron.
Therapeutic options for nonhospitalized patients with omicron COVID-19 variant
COVID-19 cases can result in serious illness, hospitalizations, and deaths. Antiviral therapies can help treat patients with mild to moderate COVID-19 infection. This therapy is available through oral administration , making it easier for patients to take. These therapies are to be taken twice a day for 5 consecutive days. It is important for the full course to be completed and should not exceed the 5 days.
Provider operations manual
Statement about allocation of Paxlovid
Statement about allocation of Paxlovid On Dec. 22, 2021, the Food and Drug Administration (FDA) authorized Pfizer’s Paxlovid under emergency use for treatment of mild to moderate COVID-19 infection in certain adults and children. Paxlovid is used for patients who are at high risk for progression to severe COVID-19, including hospitalization or death.
On Dec. 27, 2021, the US Department of Health and Human Services (HHS) authorized jurisdictions to begin ordering Paxlovid. The supply for Paxlovid is currently constrained and is anticipated to be in high demand due to the increased efficacy of 88%. With information collected via survey, prioritization will be given to FQHC’s with pharmacy partnership, Tribal Health Centers, and some Regional Coordinating Hospitals. Expansion for distribution will be evaluated depending on an increase in supply. You will be invited to submit an order at a time that supply can accommodate for increased number of requests and we can expand access by tiers.
People who are interested in receiving Paxlovid should contact their healthcare provider.
Statement about Molnupiravir and Ordering
Molnupiravir is currently in relatively surplus supply and we invite all eligible providers to order. Molnupiravir is meant to be dispensed through pharmacies. You are considered a "ready" provider to receive Molnupiravir if you have the capacity to do one of the following:
- test and treat directly in your clinic (prescription to be sent to a dispensing pharmacy on site)
- test and prescribe for pickup at an affiliated pharmacy (pharmacy not on site, but prescribing relationship present)
- not able to test, but can treat and are able to outreach to ensure your patients can reach you for treatment (if they access testing outside your facility)
If you meet the above criteria, the Oregon Health Authority invites you to
fill out the request survey.
Thank you for your commitment in improving access to therapeutics across Oregon.
Statement on eligibility to be dispensing provider
Molnupiravir is not recommended in pregnancy/lactation and is only authorized for patients 18 and over due to mutagenicity concerns in bone and cartilage of adolescents.
Paxlovid has multiple drug-drug interactions and is contraindicated in patients with severe kidney and liver disease and in some patients with HIV with recent ritonavir use due to concerns for resistance.
These drugs are meant to be dispensed through pharmacies. An ordering provider will need either a dispensing pharmacy on-site, or a relationship arranged with a partner pharmacy that would allow you to protect your doses for your patients.
You are considered a "ready" provider to receive product if you have the capacity to do one of the following:
- Test and treat directly in your clinic (prescription to be sent to a dispensing pharmacy on site)
- Test and prescribe for pickup at a partner pharmacy (pharmacy not on site, but prescribing relationship present)
- Not able to test, but can treat and are able to outreach to ensure your patients can reach you for treatment (if they access testing outside your facility)
Due to limited supply, Oregon Health Authority (OHA) is working to equitably distribute our federal allocation.
Weekly federal allocations and provider requests
Distribution and Administration of COVID-19 Therapeutics from the U.S. Department of Health and Human Services
Jan. 5, 2022 update
Please note guidance to providers for utilization of therapeutics in times of constrained supply. Please pay special attention to slides 6-9 for decision making guides and recommendations for prioritization of patients.