Government of New Brunswick

Coronavirus (COVID-19) Drug Therapy

Overview


Vaccination is the most effective way to prevent SARS-CoV-2 infections. For individuals who are more likely to get very sick from COVID-19, drugs are available that can reduce the chances of severe illness and death.

The COVID-19 drug therapy is available at no cost to any patient (regardless of permanent residence). Patients must meet the eligibility requirements outlined below.

Pharmacists must ensure that each prescription for the eligible COVID-19 drug therapy is accompanied by the signed and completed Eligibility Form.

 

Eligible Drugs and Services

 
  • nirmatrelvir / ritonavir (Paxlovid) 150/100 mg, DIN 02524031
  • nirmatrelvir / ritonavir (Paxlovid) 150/100 mg, DIN 02527804
  • Refusal to fill nirmatrelvir / ritonavir (Paxlovid) prescription, PIN00904798

 

Treatment


nirmatrelvir / ritonavir (Paxlovid)

Symptomatic adults 18 years of age and older must meet all of the following criteria:

  • Symptoms began in the last 5 days
  • Tested positive for COVID-19
  • Are at higher risk of severe outcomes

Patients may be considered at higher risk of severe outcomes if they:

  • are not fully vaccinated,
  • are an older adult 
  • have one or more chronic medical conditions,
  • are moderate to severely immunocompromised, due to a medical condition or treatment.

Pharmacists may refuse to fill a prescription for Paxlovid from another prescriber due to a drug interaction, medical condition or if the patient is determined to be ineligible for Paxlovid. Pharmacists are eligible to claim a refusal to fill fee using the PIN listed in the Claim Submission section.

 

Table 1

Service

PIN

Fee

Refusal to fill a nirmatrelvir / ritonavir (Paxlovid) prescription

00904798

$11

For information related to ordering, assessment and diagnosis, refer to the following resources:

Documentation Requirements


The hard copy of the prescription, along with the following form must be retained:

 

Claim Submission


Manual claims will not be accepted. Claims must be submitted online and include the following information:

Field Information Required

Carrier ID

NB

Group Number or Code

I (Note: this also applies to New Brunswick Drug Plans beneficiaries).

Client ID

Patient’s NB Medicare number. (Note: this also applies to New Brunswick Drug Plans beneficiaries).

For individuals from out of province, temporarily residing in New Brunswick and who have not been issued an NB Medicare number, enter “999 999 999” in place of the Medicare number.

Note: If there is a requirement for a pharmacy to submit more than one claim on the same day for the same DIN under this pseudo Medicare number, subsequent claims must be submitted with Intervention Code “MG”.

Patient Code

Leave blank

Patients Name

Patient’s first and last name

Patients DOB

Patient’s date of birth

Prescriber ID

 Prescriber’s license or registration number (see NB Drug Plans Claim Submissions web page).

Prescriber ID Reference Code

Code identifying a prescriber’s licensing body (see NB Drug Plans Claim Submissions webpage).

DIN/PIN

 nirmatrelvir / ritonavir (Paxlovid) 150/100mg, DIN 02524031
nirmatrelvir / ritonavir (Paxlovid) 150/100mg, DIN 02527804
Refusal to Fill nirmatrelvir / ritonavir (Paxlovid), PIN 00904798

Quantity

1

Days Supply

Number of days’ dispensed (see NB Drug Plans Claim Submissions  web page).

Drug Cost/Product Value

Zero

Drug Upcharge

Zero

Professional Fee

$11.00

Intervention and Exception Code

Applicable CPhA codes for those patients meeting the criteria described above

Pharmacy Ordering Information


Nirmatrelvir / ritonavir (Paxlovid) is available to order from McKesson Canada. Pharmacies are encouraged to keep one box (one treatment course) of nirmatrelvir / ritonavir (Paxlovid) in stock as initiation of nirmatrelvir / ritonavir (Paxlovid) therapy is time sensitive. Nirmatrelvir / ritonavir (Paxlovid) will be provided to pharmacies at no cost. Pharmacies can order a maximum of 15 boxes of nirmatrelvir / ritonavir (Paxlovid) from McKesson Canada per day. If more than 15 boxes are required on a particular day, McKesson Canada can grant an urgent access supply. See the McKesson Canada nirmatrelvir / ritonavir (Paxlovid) Ordering Document for additional details.

 

Pharmacy Audits


All claims submitted by participating providers for reimbursement are subject to audit and recovery. All claims must have documentation of the completed Eligibility Form. The retention period for the Eligibility Form is consistent with the New Brunswick Pharmacy Regulation and related Practice Standards and guidelines. 

 

Resources


Government of NB web pages:

Clinical Resources:

Health Canada Product Monograph:

Pharmacy Ordering Resource:

Eligibility Form: