Provider Alert! Addition of Paxlovid (Pfizer Oral Covid-19 Drug) to Formulary
Date: January 8, 2024
Attention: Providers
Effective date: January 4, 2024
Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective January 4, 2024, the Texas Health and Human Services (HHS) added Paxlovid to the formulary.
Paxlovid (nirmatrelvir co-packaged with ritonavir) is an oral antiviral tablet, is indicated for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.
How this impacts providers:
Please see below for the list of impacted drugs (of note, the approval is NDC-specific):
| Medication | Medication NDC | Type of Change | Effective Date |
| PAXLOVID 150-100 MG DOSE PACK | 00069531720 | FORMULARY ADDITION | January 4, 2024 |
| PAXLOVID 300-100 MG DOSE PACK | 00069532130 | FORMULARY ADDITION | January 4, 2024 |
Next step for Providers: Prescribers are encouraged to educate patients about Paxlovid, including the importance of early intervention and adherence to prescribed treatment regimens. For detailed information on Paxlovid, including prescribing information and eligibility criteria, please refer to the drug’s official prescribing information.
If you have any questions, please email TCHP Pharmacy at: tchppharmacy@texaschildrens.org.
For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
