Published on January 31, 2022

COVID-19 Outpatient Treatments

The U.S. Food and Drug Administration (FDA) has issued emergency use authorization (EUA) for the following outpatient medications, listed below in order of treatment preference as recommended by the National Institutes of Health (NIH).

According to guidance from the U.S. Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH), along with that of our own physicians, certain monoclonal antibody infusions are showing not to be as effective as others against COVID-19. There are currently several therapies – Paxlovid (an oral antiviral), Veklury (remdesivir, an antiviral administered by infusion), and molnupiravir (another oral antiviral) – that are showing to be effective in treating the current dominant Omicron variant of COVID-19.

The FDA has issued emergency use authorization (EUA) for the following outpatient medications, listed below in order of treatment preference as recommended by the NIH:

  • Preferred therapies (listed in order of preference):
    • Paxlovid (nirmatrelvir tablets and ritonavir tablets) is authorized for the treatment of mild-to-moderate COVID-19 in adults and certain pediatric patients with COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death.
    • Remdesivir (Veklury) is an approved antiviral drug for the treatment of mild-to-moderate COVID-19 adults and certain pediatric patients age 12 years and older with COVID-19. Not recommended in severe renal (eGFR <30) or liver failure.
  • Alternative therapies (listed in alphabetical order) for use ONLY when neither of the preferred therapies are available, feasible to use, or clinically appropriate:
    • Bebtelovimab is authorized for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options approved or authorized by FDA are not accessible or clinically appropriate.
    • Molnupiravir is authorized 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, and for whom alternative COVID-19 treatment options authorized by the FDA are not accessible or clinically appropriate.

Note: These treatments are only viable options if given within a certain number of days from symptom onset. (See fact sheets linked below.)

Learn more about these treatments at fda.gov.

Accessing Outpatient Treatments - What Patients Need to Know

Ozarks Healthcare is following a protocol recommended by the NIH to prioritize those at highest risk for progression to severe COVID-19 disease. Ozarks Healthcare has limited quantities of COVID-19 antiviral treatments, and they are available by order or prescription only. Demand for these treatments is expected to outpace supply. Please contact your healthcare provider to review treatment options.

For Prescribing Providers

Please follow these steps to refer a patient for an outpatient IV/IM COVID-19 treatment and to access eligibility forms for oral medication options through Ozarks Healthcare:

  1. Determine patient’s tier of eligibility based on the criteria below. Note: Ozarks Healthcare will focus on filling prescriptions and orders for Tier 1 patients first, and then expand to additional tiers as supply allows (see table below for details).
  2. If patient is in an eligible tier, check the table below for inventory status.
  3. If the treatment is in stock, submit an order by following the instructions and completing the appropriate forms listed below the table. For oral medications, an eligibility form must be submitted in addition to a valid prescription.

Please do not submit orders or prescriptions for treatments that are not in stock.

COVID-19 Outpatient Antiviral Treatment Availability

The information in the table below is intended for provider use only. COVID-19 antiviral treatments are available by prescription or order form only. Treatments will be available on a first-come, first-serve basis for those who meet eligibility requirements. The following table will be updated regularly based on supply. Please do not send orders or prescriptions for treatments that are not currently available. No wait-lists are available due to the time-sensitive nature of treatments. Contact info listed on forms may change, so please continue to refer back to this page for updates.

Tiered Eligibility and In-stock Determination:

TIER
RISK GROUPS
IS OZARKS HEALTHCARE CURRENTLY TREATING?
CURRENT TREATMENT OPTIONS:
IN STOCK:

1

Immunocompromised individuals not expected to mount an adequate immune response to COVID-19 vaccination or SARS-CoV-2 infection due to their underlying conditions, regardless of vaccine status (see CDC list of Immunocompromising Conditions)

OR

Unvaccinated individuals at the highest risk of severe disease

- (anyone aged ≥75 years)

- (anyone aged ≥65 years with 1+ clinical risk factors)

YES

Paxlovid
Bebtelovimab
Remdesivir
Molnupiravir

YES
YES
NO
YES

2

Unvaccinated individuals at risk of severe disease not included in Tier 1

- (anyone aged ≥65 years)

- (or anyone aged <65 years with 1+ clinical risk factors)

YES

Paxlovid
Bebtelovimab
Remdesivir
Molnupiravir

YES
YES
NO
YES

3

Vaccinated individuals at high risk of severe disease

- (anyone aged ≥75 years)

- (or anyone aged ≥65 years with 1+ clinical risk factors)

Note: Vaccinated individuals who have not received a COVID-19 vaccine booster dose are likely at higher risk for severe disease; patients in this situation within this tier should be prioritized for treatment.

YES

Paxlovid
Bebtelovimab
Remdesivir
Molnupiravir
YES
YES
NO
YES

4

Vaccinated individuals at risk of severe disease not included in Tier 3

- (anyone aged ≥65 years)

- (or anyone aged <65 years with 1+ clinical risk factors)

Note: Vaccinated individuals who have not received a COVID-19 vaccine booster dose are likely at higher risk for severe disease; patients in this situation within this tier should be prioritized for treatment.

YES

Paxlovid
Bebtelovimab
Remdesivir
Molnupiravir

YES
YES
NO
YES
*Tiers adapted from NIH recommendations*
IMPORTANT: Inventory information is updated as stock status changes. Please DO NOT send prescription orders if drug status is out of stock. Check back and wait for the drug to be in stock to order.

Examples of High-risk/Comorbid Conditions that predispose to progression to severe COVID-19 (from NIH, CDC, and FDA sites).

Treatment Options for COVID-19-positive Patients

Healthcare providers ONLY may complete the order forms listed below.

For healthcare providers: select the day from symptom onset below that matches your patient. Review the FDA EUA fact sheet if you are not familiar with the medication you select. Under each treatment option, find either an order form or eligibility form, which must be completed for each patient. For IV and IM treatment options, completing the order form is sufficient. For oral antivirals, a prescription (paper or electronic) must accompany the required eligibility form. Consent forms and FDA EUA fact sheets are available for patients below and will also be available at the time of treatment.

A. COVID-positive beyond 10 days from symptom onset

Regardless of supply on hand, do not qualify for currently available defined treatments in outpatient setting for COVID-19, based on current FDA EUA guidance.

B. COVID-positive at 8-10 days from symptom onset

Regardless of supply on hand, do not qualify for currently available defined treatments in outpatient setting for COVID-19, based on current FDA EUA guidance.

C. COVID-positive at 6-7 days from symptom onset

Consider the following, listed in order of NIH recommended preference, based on current FDA EUA guidance and NIH Tier eligibility. Logistical and supply constraints may impact availability (reference table above).

1. Remdesivir (Veklury) for Outpatient

Remdesivir (Veklury) EUA Fact Sheet for Healthcare Providers

Remdesivir (Veklury) EUA Fact Sheet for Patients, Parents, and Caregivers

Ozarks Healthcare Remdesivir (Veklury) Order Form/Patient Eligibility Form for Providers

Remdesivir (Veklury) Patient Consent Form

2. Bebtelovimab

Bebtelovimab EUA Fact Sheet for Healthcare Providers

Bebtelovimab EUA Fact Sheet for Patients, Parents, and Caregivers

Ozarks Healthcare Bebtelovimab Order Form/Patient Eligibility Form for Providers

Bebtelovimab Patient Consent Form

D. COVID-positive at days 1-5 from symptom onset

Consider the following, listed in order of NIH recommended preference, based on current EUA guidance and NIH Tier eligibility. Logistical and supply constraints may impact availability (reference table above).

1. Paxlovid

Paxlovid EUA Fact Sheet for Healthcare Providers

Paxlovid EUA Fact Sheet for Patients, Parents, and Caregivers

Ozarks Healthcare Paxlovid Patient Eligibility Form for Providers

Check Paxlovid drug-drug interactions at www.covid19-druginteractions.org/.

2. Remdesivir

Remdesivir (Veklury) EUA Fact Sheet for Healthcare Providers

Remdesivir (Veklury) EUA Fact Sheet for Patients, Parents, and Caregivers

Ozarks Healthcare Remdesivir (Veklury) Order Form/Patient Eligibility Form for Providers

Remdesivir (Veklury) Patient Consent Form

3. Bebtelovimab

Bebtelovimab EUA Fact Sheet for Healthcare Providers

Bebtelovimab EUA Fact Sheet for Patients, Parents, and Caregivers

Ozarks Healthcare Bebtelovimab Order Form/Patient Eligibility Form for Providers

Bebtelovimab Patient Consent Form

4. Molnupiravir

Molnupiravir EUA Fact Sheet for Healthcare Providers

Molnupiravir EUA Fact Sheet for Patients, Parents, and Caregivers

Ozarks Healthcare Molnupiravir Patient Eligibility Form for Providers

Prophylactic Treatment Options for COVID-19-negative Patients

A. Not COVID-positive and not expected to mount an adequate response to vaccination (or documented severe allergic reaction to COVID vaccine or components)

1. EVUSHELD, an intramuscular (IM) monoclonal antibody injection for pre-exposure prophylaxis is available for specific patient populations as per current FDA EUA guidance. EVUSHELD must be prescribed by a healthcare provider.

Current EVUSHELD Availability at
Ozarks Healthcare:
IN STOCK

EVUSHELD EUA Fact Sheet for Healthcare Providers

EVUSHELD EUA Fact Sheet for Patients, Parents, and Caregivers

Ozarks Healthcare EVUSHELD Order Form/Patient Eligibility Form for Providers

EVUSHELD Patient Consent Form

B. Not COVID-positive and received 2 doses of Moderna or Pfizer vaccine or 1 dose of Johnson & Johnson's vaccine, is not boosted

Booster vaccination, in eligible population, is effective current option offering protection against severe COVID-19.

Ozarks Healthcare Pharmacy COVID-19 Vaccination Availability

C. Not COVID-positive and previously partially vaccinated (one dose of Moderna or Pfizer vaccine)

Completing vaccination series, in eligible population, is effective current option offering protection against severe COVID-19.

Ozarks Healthcare Pharmacy COVID-19 Vaccination Availability

D. Not COVID-positive and not previously vaccinated

Vaccination against COVID-19, in eligible population, is effective current option offering protection against severe COVID-19.

Ozarks Healthcare Pharmacy COVID-19 Vaccination Availability

Contact your primary care provider to inquire about getting a referral, order or prescription.

Outpatient Infusion Location

Ozarks Healthcare's outpatient monoclonal antibody infusion site location will be relayed to the patient/patient's caregiver at the time of scheduling:

1100 Kentucky Ave.

West Plains, MO 65775

Staff from Ozarks Healthcare's Scheduling Department will contact patients to schedule appointments for monoclonal antibody infusions.

Outpatient IM Injection (EVUSHELD) Location

Ozarks Healthcare's outpatient IM EVUSHELD injection site is located in its Shaw Medical Building in the Infusion Suite of its Cancer Treatment Center:

1111 Kentucky Ave.

West Plains, MO 65775

Staff from Ozarks Healthcare's Cancer Treatment Center will contact patients to schedule appointments for EVUSHELD.

Outpatient Pharmacy Location

Ozarks Healthcare's current pharmacy location for oral antiviral prescriptions is located at Parkway Center in West Plains:

1211 Porter Wagoner Blvd.

#18 (Parkway Center)

West Plains, MO 65775