Enough Paxlovid to treat Covid-19 in at-risk adults, but it is no longer free: MOH

SINGAPORE – There is enough supply of Paxlovid, an antiviral medication to treat adults at high risk of severe Covid-19, and the Ministry of Health (MOH) will release the stockpile only when the need arises.

However, Paxlovid is no longer free as MOH has stopped fully covering the costs of the drug in primary care settings and has been subsidising it under the Medication Assistance Fund since November 2024, the ministry told The Straits Times.

Pfizer’s Paxlovid drug is an oral treatment that comprises two separate types of medication – nirmatrelvir, an antiviral medicine, and ritonavir, which helps keep nirmatrelvir active in the body at higher concentrations for longer to combat the virus.

Paxlovid was rolled out in phases

in 2022 at selected polyclinics and Public Health Preparedness Clinics (PHPCs) to high-risk patients to reduce their likelihood of hospitalisation.

These patients include those who are immunocompromised and undergoing treatment, the elderly, those who are obese, and those with active cancer or severe lung, heart or kidney disease.

MOH had said that from March 18, 2022, eligible patients may be referred to the participating PHPCs or polyclinics for a consultation and prescription of Paxlovid, if appropriate.

However, some patients had given feedback that they were not able to get access to the antiviral medicine from clinics on the list. 

Responding to ST queries on why patients were unable to get the antiviral treatment from its

list of 128 PHPCs

, an MOH spokesman said: “As general practitioners (GPs) may not stock Paxlovid in their clinics due to its cost or other operational reasons, they may issue a prescription for Paxlovid if they assess that their patients are clinically eligible.

“Those who are prescribed Paxlovid by their GPs may purchase the medication at selected Guardian, Unity and Watsons retail pharmacies,” he added.

While MOH fully covered the costs of Paxlovid for use in the eligible primary care settings when the therapy was rolled out in 2022, it had since stopped doing so.

Instead, immunocompromised Singaporeans and permanent residents aged 18 years or older and with mild to moderate Covid-19 infection can receive subsidies of up to 75 per cent under the Medication Assistance Fund from November 2024.

This is only when they obtain a course of Paxlovid through prescription from selected public healthcare institutions. The typical cost of Paxlovid ranges between $274 and $1,095, depending on the applicable subsidy rate for individual patients.

Covid-19 jabs under the National Vaccination Programme will continue to be offered free to all Singaporeans, permanent residents, long-term pass holders and certain short-term pass holders, as it remains Singapore’s “first line of defence” against the disease, said MOH, which added that Singapore’s high vaccination rates enabled Singapore to arrive at the Covid-19 endemic norm today.

Paxlovid was the first oral tablet approved by the Health Sciences Authority for use in Singapore in January 2022, and is currently the only oral drug to treat mild to moderate Covid-19 infection.

Clinical data showed that it could reduce Covid-19-related hospitalisation or death by 88.9 per cent when given within three days from the onset of symptoms.

Its efficacy rate was 87.8 per cent when given within five days of symptoms appearing.