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

  • 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.
  • Sotrovimab is authorized for the treatment of COVID-19 in adults and pediatric patients.
  • 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. Paxlovid and molnupiravir within five (5) days; and sotrovimab within 10 days.

Learn more about these treatments at fda.gov.

How can I access these outpatient treatments?

MU Health Care has limited quantities of COVID-19 antiviral treatments, and they are available by prescription only. Demand for these treatments is expected to outpace supply, so MU Health Care is following the below outpatient protocol.

If you are a patient with a test-confirmed COVID-19 diagnosis and you are experiencing symptoms, you may be eligible for an outpatient treatment option, based on when your symptoms started. See section above for timeframes. You can contact your primary care physician to get a referral. Note: Only contact your doctor if we have medication in stock.

If you are a prescribing provider, please follow these steps:

  1. Determine patient’s tier of eligibility based on the NIH table below. Note: MU Health Care will focus on filling prescriptions for tier 1 patients first, and then expand to additional tiers as supply allows.
  2. If patient is in an eligible tier, check the inventory table below for inventory status.
  3. If the treatment is in stock, submit an electronic order by following the instructions below.

Note: If you are an MU Health Care provider looking for the inpatient treatment protocol, please see the "Physician resources" section of our internal site.

COVID-19 outpatient antiviral treatment protocol

This protocol is for providers only. COVID-19 antiviral treatments are available by prescription only.

Step 1: Tiered eligibility determination

MU Health Care is following NIH Treatment Guidelines to determine patient eligibility and prioritize treatment. While supply is limited, only patients in eligible tiers will receive antiviral treatment.

Tier Risk Groups Is MUHC currently treating?
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 or anyone aged ≥65 years with additional risk factors)
YES
2 Unvaccinated individuals at risk of severe disease not included in Tier 1 (anyone aged ≥65 years or anyone aged <65 years with clinical risk factors) YES
3 Vaccinated individuals at high risk of severe disease (anyone aged ≥75 years or anyone aged ≥65 years with 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.
NO
4 Vaccinated individuals at risk of severe disease (anyone aged ≥65 years or anyone aged <65 years with 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.
NO

Step 2: Inventory status

Note: Treatment options listed in order of NIH preference.

Drug In Stock?
Paxlovid (nirmatrelvir tablets and ritonavir tablets) YES
Sotrovimab YES
Molnupiravir YES

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.

Step 3: Prescribing options

These options are for providers only. COVID-19 antiviral treatments are available by prescription only.

  • Paxlovid (nirmatrelvir tablets and ritonavir tablets)
  • Sotrovimab
    • Providers should call 573-882-6985 to refer a patient for infusion treatment.
  • Molnupiravir
    • Send prescription electronically to Mizzou Pharmacy – South Providence.
    • Reference the Molnupiravir EUA fact sheet for dosing information, contraindications, and drug-drug interactions.

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.