Retiree calls out Sask. gov't for not communicating changes to accessing COVID-19 drug Paxlovid

Paxlovid is an oral Covid-19 antiviral therapeutic treatment. In April, changes were made to how patients gain access to the drug in Saskatchewan, but no public announcement was made.  (Cory Herperger/CBC/Radio-Canada - image credit)
Paxlovid is an oral Covid-19 antiviral therapeutic treatment. In April, changes were made to how patients gain access to the drug in Saskatchewan, but no public announcement was made. (Cory Herperger/CBC/Radio-Canada - image credit)

A 63-year-old Saskatoon man says he has lost faith in the Saskatchewan government's health-care system, and he may move provinces because of it.

A big issue, he says, is that the province does not properly communicate new health-care information with the public.

When Greg Pletz contracted COVID-19 in mid-May, he called the Saskatchewan 811 HealthLine and was told to contact his general practitioner for a prescription forPaxlovid, Pfizer's antiviral drug.

But that process proved to be far more difficult than he imagined. That's because the province made changes concerning Paxlovid prescriptions, but did not publicly announce those changes, Pletz said.

Pletz has numerous health issues, including chronic obstructive pulmonary disease (COPD) and diabetes. These, his doctor told him, qualified him for a Paxlovid prescription and full coverage of the medication.

Paxlovid is for adults in the early days of infection who have mild to moderate symptoms of COVID-19 and who have a high risk of deteriorating into severe illness and requiring hospitalization.

Treatment with Paxlovid must start within five days of symptom onset. The medication consists of three tablets taken every 12 hours for five days.

Pletz began exhibiting COVID-19 symptoms on Wednesday, May 15, and his doctor wanted him on the medication by May 17, a Friday evening.

A positive COVID-19 rapid test result taken Aug. 31.
A positive COVID-19 rapid test result taken Aug. 31.

Pletz began exhibiting COVID-19 symptoms on Wednesday, May 15, and his doctor wanted him on Paxlovid by May 17. But due to confusion around new forms that must be filled out first, Pletz said he never got to take the medication. (CBC/Radio-Canada)

Pletz said he immediately contacted a pharmacy to fill the prescription, but they said they did not have it in stock. So Pletz then contacted another pharmacy. This one told him they could order Paxlovid for him, but that his doctor did not submit the proper, new six-page form.

"I explained to [my doctor] what was going on. He wasn't aware that he had to fill out a different form," Pletz said.

CBC searched for information on this new form in May. The University of Saskatchewan website had it listed as the Paxlovid PAR form. That information was not available on either the Saskatchewan Health Authority's or the province's websites. As of June 4, information on the PAR form is no longer publicly accessible on the U of S website.

In May, the Health Ministry told CBC there are over 200 pharmacies in the province participating in dispensing Paxlovid. But the Saskatchewan College of Pharmacy Professionals placed a temporary hold on Saskatchewan pharmacists prescribing Paxlovid as of April 1.

The ministry attributed this decision to a "significantly reduced demand for Paxlovid over the winter and spring, and anticipated reduced demand over the summer."

In April the PAR form became mandatory for doctors and nurses to fill out for patients in need of the drug. But Pletz said that neither the 811 nurse he spoke with nor his doctor knew about the changes.

"If I had knowledge that this new form was required, I would have made sure my doctor was aware of it. When I talked to the 811 HealthLine, if they had that information, it would have made a difference," Pletz said.

Out of time

While the prescription meant Pletz could get the drug, without the new form he said he was told he would have to pay approximately $1,400 out of pocket. Pletz said he was not willing to pay that amount.

Pletz asked the pharmacy how long it would take for it to order Paxlovid if they received the proper form from his doctor. While normally it takes one day, the pharmacy told Pletz that the order would not go through until after the May long weekend.

"By that point, I was past the criteria for the treatment to be effective."

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The 63-year-old told CBC he always believed he would have medical coverage as he aged. Pletz said he has spent the entire pandemic being extra careful to protect himself with boosters and masks, among other things. But he found comfort in the fact that if he did get COVID-19, he would have a good shot at getting the antiviral drug.

Learning that wasn't the case was a big shock to Pletz. He said it made him feel unsafe in Saskatchewan's health-care system.

"It very much heightened my anxiety. Just fear," he said.

Pletz and his wife have discussed moving to another province, likely B.C., out of concerns for their health for years. Two of Pletz's previous doctors have moved there to work.

"It's sad to say. I've lived here all my life and I just retired a few years ago. But if I cannot get health care in Saskatchewan, I'm left with no choice but to move to a district in Canada that can supply me with health care."

Coverage of Paxlovid transitioning

CBC reached out to the Ministry of Health for a statement about how the changes concerning Paxlovid were communicated.

The ministry said that in September 2023, the Public Health Agency of Canada told provinces and territories that Paxlovid would no longer be federally supplied as of the end of March 2024. It said the last remaining current stock expired May 31, 2024.

The province said Paxlovid continues to be available to residents of Saskatchewan after the publicly funded supply expired.

Pfizer Paxlovid oral Covid-19 antiviral theraputic treatment. See close up of tablets on 21 Feb 2021. Traitement thérapeutique antiviral oral Covid-19 de Pfizer Paxlovid.
Pfizer Paxlovid oral Covid-19 antiviral theraputic treatment. See close up of tablets on 21 Feb 2021. Traitement thérapeutique antiviral oral Covid-19 de Pfizer Paxlovid.

Treatment with Paxlovid must start within five days of symptom onset. The medication consists of three tablets taken every 12 hours for five days. (Cory Herperger/CBC Radio-Canada)

It said it is working on transitioning coverage of Paxlovid from the federal program to the provincial drug plan. Under the Saskatchewan drug plan, Paxlovid will be an eligible exception drug status benefit for those who meet criteria.

When CBC asked the ministry if the Saskatchewan Health Authority put a statement out to the Saskatchewan public that pharmacists no longer prescribe Paxlovid, it did not provide an answer.

Instead, in an emailed statement, the ministry said "pharmacists approached by the public requesting a prescription for Paxlovid should be directing patients to a doctor or nurse practitioner."

Pletz said he would have liked to hear this information in an announcement months ago.

"I would like the government to be held accountable for the lack of information given to us," Pletz said.

"It almost seems like this government does not want to talk about COVID."

On May 23, the province told CBC that the government's website would be updated at the end of that month to reflect the changes around Paxlovid in Saskatchewan.

As of June 4, the province has updated the site, stating that the decision to prescribe an antiviral medication will be made by a physician or nurse practitioner, not a pharmacist. However, there is no mention of any of the other recent decisions around access.