COVID-19 outpatient therapeutic information for providers

Provider guidance on the use of outpatient therapeutics 

Patients recommended for treatment:

1. Recently diagnosed with symptomatic COVID-19 AND 
2. Mild or moderate disease NOT requiring hospitalization AND 
3. At risk for progression to severe COVID-19, due to any one of the following: 
   • Age 50 or older, esp anyone age 65 or older
   • Under age 50 with risk factors for severe disease 
   • immunocompromised 
   • Unvaccinated or not completely vaccinated 
   • Pregnant 

Treatment options for symptomatic individuals

• Nirmatrelvir/ Ritonavir (Paxlovid)
• Remdesivir (Veklury)
• Molnupiravir (Lagevrio) 
• Bebtelovimab 

Pre-exposure prophylaxis

• Tixagevimab/cilgavimab (Evusheld) 

Interim Health Advisory

CDC Health Advisory (May 24, 2022) - COVID-19 Rebound After Paxlovid Treatment

Additional Resources for Providers

NIH - Therapeutic Management of Nonhospitalized Adults with COVID-19

CDPH’s Treatment Information for Health Professionals

FDA’s Paxlovid Patient Eligibility Screening Checklist Tool for Prescribers

COVID-19 drug interaction checker

Test-to-treat therapeutics locator

Prescribing therapeutics for eligible patients in San Francisco

Prescriptions can now be sent to any Walgreens, CVS, and Safeway to reduce barriers. Medications will either be stocked or redistributed internally.  

A full list of pharmacies and clinics can be found at covid.gov 

Most prescriptions should be placed electronically through your EHR.  However, if having difficulty, some pharmacies can accommodate phone prescriptions. 

Your prescription must include the date of the patient's symptom onset, if relevant and their eligibility criteria.

If you are a provider who works at one of the following medical facilities (list below), you may access therapeutics within your own health system as well. Contact your department to determine which internal pharmacies have supplies.

• University of California San Francisco (UCSF)
• Kaiser Permanente
• California Pacific Medical Center (CPMC)
• Northeast Medical Services (NEMS) 
• Zuckerberg San Francisco General (ZSFG)
• Skilled Nursing Facilities

Patients without insurance or a healthcare provider

Test to Treat sites can both test for SARS-CoV-2 and dispense COVID-19 treatments regardless of insurance status.  

Sites providing test-to-treat in San Francisco can be found on: https://sf.gov/get-treated-covid-19  

Current sites participating in the federal program can be found on the Department of Health and Human Services’ Test to Treat Locator, which can be found here: https://covid-19-test-to-treat-locator-dhhs.hub.arcgis.com.

Congregate settings & Skilled Nursing Facilities

Congregate settings can access Test to Treat sites listed above

Skilled nursing facility prescribers should order through their internal pharmacy.

Delivery options & cost

See table below for more information on delivery options and costs.