Government of New Brunswick


Patients are eligible to receive certain COVID-19 drug therapies from a primary care practitioner. Patients must meet the eligibility requirements as outlined below.

In addition to a prescription, a completed Eligibility Form is required.

Pharmacists must ensure that each prescription for approved COVID-19 drug therapies is accompanied by the applicable signed and completed Eligibility Form.

Vaccination is the most effective way to prevent SARS-CoV-2 infections. For individuals who are more likely to get very sick from COVID-19, medications are available that can reduce your chances of severe illness and death.
 

 
  • nirmatrelvir / ritonavir (Paxlovid) 150/100 mg, DIN 02524031
  • nirmatrelvir / ritonavir (Paxlovid) 150/100 mg, DIN 02527804
  • tixagevimab /cilgavimab (Evusheld), DIN 02526271
  • Refusal to fill nirmatrelvir / ritonavir (Paxlovid) prescription, PIN00904798

 


nirmatrelvir / ritonavir (Paxlovid)

Paxlovid is recommended for adults over 18 if they:

  • have developed symptoms that began in the last 5 days, and
  • have tested positive for COVID-19, and
  • are at higher risk of severe outcomes.

Patients may be considered at higher risk of severe outcomes if they:

  • are not fully vaccinated,
  • are an older adult – your risk increases with age,
  • have one or more chronic medical conditions,
  • are moderate to severely immunocompromised, due to a medical condition or treatment.

Pharmacists may refuse to fill a prescription for Paxlovid from another prescriber due to a drug interaction, medical condition or if the patient is determined to be ineligible for Paxlovid. Pharmacists are eligible to claim a refusal to fill fee using the PIN listed in the Claim Submission section.

 

Table 1

 

PIN

Fee

Refusal to fill a nirmatrelvir / ritonavir (Paxlovid) prescription

00904798

$11

For information related to assessment and diagnosis refer to the Firstline Algorithm.


tixagevimab /cilgavimab (Evusheld)

Tixagevimab /cilgavimab (Evusheld)  is not recommended to be given concurrently with COVID-19 vaccinations. It is recommended that tixagevimab /cilgavimab (Evusheld) should be administered at least 2 weeks following COVID-19 vaccination.

For information related to the use of tixagevimab /cilgavimab (Evusheld)  in the context of COVID-19 vaccination please refer to the National Advisory Committee on Immunization (NACI) guidance document.
 

Patient eligibility as determined by the prescriber on the tixagevimab /cilgavimab (Evusheld) Eligibility Form
Intervention Code

18 years of age or older and Immunocompromised (If illness not on list below, not eligible):

  • Allogeneic hematopoietic stem cell transplant (within 2 years or taking immunosuppressant therapy)
  • Undergoing therapy for hematological malignancies
  • Receiving anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22)
  • Receipt of chimeric antigen receptor (CAR)-T-cell therapy
  • Other select patients with severe primary or secondary immunodeficiency for whom the treating physician determines that benefit outweighs the risk   

MJ

18 years of age or older with contraindications to COVID-19 vaccines AND at high risk of poor outcomes, including severe disease, hospitalization, or death (If illness not on list below, not eligible):

  • Obesity (BMI > 30)
  • Chronic lung disease (including asthma)
  • Chronic metabolic disease (including diabetes)
  • Chronic kidney or liver disease
  • Neurodevelopmental disorders
  • Sickle cell disease
  • Immunosuppression, or receiving immunosuppressive therapy.

DV


Prescriptions written by a primary care practitioner, along with one of the following forms::

 


Manual claims will not be accepted. Claims must be submitted online and include the following information:

Field Information Required

Carrier ID

NB

Group Number or Code

I (Note: this also applies to New Brunswick Drug Plans beneficiaries).

Client ID

Patient’s NB Medicare number. (Note: this also applies to New Brunswick Drug Plans beneficiaries).

For individuals from out of province, temporarily residing in New Brunswick and who have not been issued an NB Medicare number, enter “999 999 999” in place of the Medicare number.

Note: If there is a requirement for a pharmacy to submit more than one claim on the same day for the same DIN under this pseudo Medicare number, subsequent claims must be submitted with Intervention Code “MG”.

Patient Code

Leave blank

Patients Name

Patient’s first and last name

Patients DOB

Patient’s date of birth

Prescriber ID

Prescriber’s license or registration number (see NB Drug Plans Claim Submissions webpage).

Prescriber ID Reference Code

Code identifying a prescriber’s licensing body (see NB Drug Plans Claim Submissions webpage).

DIN/PIN

nirmatrelvir / ritonavir (Paxlovid) 150/100mg, DIN 02524031
nirmatrelvir / ritonavir (Paxlovid) 150/100mg, DIN 02527804
tixagevimab /cilgavimab (Evusheld) 150/150mg, DIN 02526271
Refusal to Fill nirmatrelvir / ritonavir (Paxlovid), PIN 00904798

Quantity

Days Supply

Number of days’ dispensed (see NB Drug Plans Claim Submissions webpage).

Drug Cost/Product Value

Zero

Drug Upcharge

Zero

Professional Fee

$11.00

Intervention and Exception Code

Applicable CPhA codes for those patients meeting the criteria described above


Nirmatrelvir / ritonavir (Paxlovid) is available to order from McKesson Canada. Pharmacies are encouraged to keep one box (one treatment course) of nirmatrelvir / ritonavir (Paxlovid) in stock as initiation of nirmatrelvir / ritonavir (Paxlovid) therapy is time sensitive. Nirmatrelvir / ritonavir (Paxlovid) will be provided to pharmacies at no cost. Pharmacies can order a maximum of 15 boxes of nirmatrelvir / ritonavir (Paxlovid) from McKesson Canada per day. If more than 15 boxes are required on a particular day, McKesson Canada can grant an urgent access supply. See the McKesson Canada nirmatrelvir / ritonavir (Paxlovid) Ordering Document for additional details.

Tixagevimab /cilgavimab (Evusheld) is available to order from McKesson Canada. Pharmacies can order a maximum of 10 boxes of tixagevimab /cilgavimab (Evusheld) from McKesson Canada per day. See the McKesson Canada tixagevimab /cilgavimab (Evusheld) Ordering Document for additional details.
 


All claims submitted by participating providers for reimbursement are subject to audit and recovery. All claims must have documentation of the appropriate completed Eligibility Form. The retention period for the Eligibility Form is consistent with the New Brunswick Pharmacy Regulation and related Practice Standards and guidelines.