JSIS reimbursement of PAXLOVID requires introducing a request for prior authorisation* with a   prescription from either a general practitioner or a specialist, for patients who:

·        Are Covid-19 positive

·        have an increased risk of severe COVID with risk of hospitalisation: the criteria for increased risk are:

o   Age > 65 years and at least one of the following comorbidities: Body Mass Index >30 – diabetes mellitus – chronic kidney disease with glomerular filtration rate (eGFR) >29ml/min/1.73m² - chronic neurological pathology – liver disease or cirrhosis (except severe liver failure)

o   the existence of heart failure

o   the existence of chronic obstructive pulmonary disease (COPD)

o   being an Immunocompromised Patient** (due to a medical disease or treatment that has a significant impact on immunity)

Caution: CONTRAINDICATIONS TO PAXLOVID:

o If your condition requires supplemental oxygen treatment

o being treated with medications with contraindications for concomitant use with PAXLOVID

o Be on hemodialysis – peritoneal dialysis 

o Be in severe hepatic impairment (CHILD-PUGH classification: class C)

 * Given the indication of starting treatment within the 5 days of initial symptoms, if the member meets the criteria for reimbursement, JSIS may accept prior authorisations submitted a posteriori.

**immunocompromised patients = patient with at least one underlying characteristic or pathology:

• Malignant haemopathy;

• Solid cancer actively treated with cytotoxic chemotherapy;

• Solid organ or hematopoietic stem cell transplantation;

• B-cell depletion therapies for less than one year (e.g., rituximab, ocrelizumab, alemtuzumab);

• Primary immune deficiency

• HIV with CD4 count <200/mm3 and/or detectable viral load;

• Chimeric antigen receptor T cell therapy (CAR-T therapy);

• Immunosuppressive drugs such as antiproliferative agents (azathioprine, cyclophosphamide, mycophenolate mofetil), calcineurin inhibitors (tacrolimus, cyclosporine, etc.), CTLA-4 agonists (abatacept), JAK inhibitors (baricitinib, ruloxitinib, tofacitinib, etc.);

• Chronic treatment with high doses of corticosteroids (> 20mg prednisolone or equivalent per day) or Methotrexate (> 20mg per week)