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OPA COVID-19 Vaccines and Therapeutics: July 20, 2022 Update

 

New Ohio Medicaid Pharmacist COVID-19 Reimbursement Incentive New Deadline
The Ohio Department of Medicaid (ODM) and Ohio’s Managed Care plans announced that the enhanced COVID-19 administration reimbursement for pharmacists is ending on September 30, 2022. This is based on recent guidance as ODM switches to Gainwell Technologies as their single pharmacy benefit manager at the beginning of October. OPA encourages pharmacists to continue promoting COVID-19 vaccines for all eligible patients in anticipation of the discontinuation of this incentive before September.

Additional deadlines that have already been posted are as follows:

  • OutcomesMTM and CSS Health tips on COVID-19 counseling and administration ended on June 30, 2022.
  • Patient gift cards for all COVID-19 vaccines will also ended on June 30, 2022. If your pharmacy received physical gift cards for patients, please fill out the gift card trackers and send them to RxCovidTracking@centene.com.
  • Physical gift cards must be returned to the following address: Meera Patel-Zook, 4349 Easton Way Suite 201, Columbus, OH 43219.

New FDA Authorizes Emergency Use of Novovax COVID-19 Vaccine, Adjuvanted 
Last week, the U.S. Food and Drug Administration (FDA) authorized the Novovax COVID-19 Vaccine, Adjuvanted to prevent COVID-19 in individuals ages 18 and older. The vaccine is administered as a two-dose series, three weeks apart. This vaccine formulation differs from other available formulations as it contains the SARS-CoV-2 spike protein and the Matrix-M adjuvant. Adjuvants are incorporated into some vaccines to enhance the immune response of the vaccinated individual. The spike protein in this vaccine is produced in insect cells; the Matrix M-adjuvant also contains saponin extracts from the bark of the Soapbark tree native to Chile.

The Fact Sheet for Healthcare Providers Administering Vaccine warns that clinical trial data provide evidence for increased risks of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the tissue surrounding the heart) following administration of Novavax COVID-19 Vaccine, Adjuvanted. The Fact Sheet for Recipients and Caregivers suggests that symptoms typically began within 10 days following vaccination and that vaccine recipients should seek medical attention right away if they experience any of the following symptoms after vaccination: chest pain, shortness of breath, feelings of having a fast-beating, fluttering or pounding heart.

Additional Resources:


Reminder: FDA Authorizes Pharmacist Prescribed Paxlovid COVID-19 Treatment with Certain Limitations
The FDA authorized state-licensed pharmacists to prescribe Paxlovid (nirmatrelvir and ritonavir) with certain limitations. The updated Emergency Use Authorization permits pharmacists to prescribe the medication based on the following conditions:

  • The pharmacist can access patient health records to assess renal and hepatic function through:
    • Patient health records that are less than 12 months old;
    • A consultation with a healthcare provider who has an established relationship with the specific patient.
  • The pharmacist can obtain a comprehensive medication list (prescribed and non-prescribed) that the patient is currently taking to check for drug interactions through:
    • Patient health records that are less than 12 months old;
    • Patient reporting of medication history;
    • A consultation with a healthcare provider who has an established relationship with the specific patient.

Pharmacists should refer patients for clinical evaluation with a physician, advanced practice registered nurse, or physician assistant licensed or authorized under state law to prescribe drugs if any of the following apply:

  • Sufficient information is not available to assess renal and hepatic function.
  • Sufficient information is not available to assess (and/or monitor) for potential drug interactions.
  • Modification of other medications is needed due to potential drug interactions.
  • Paxlovid is not an appropriate therapeutic option based on the current Fact Sheet for Healthcare Providers.

Paxlovid is authorized for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (12 years of age and older, weighing at least 40 kilograms or about 88 pounds) with positive results of direct SARS-CoV-2 viral testing, who are at high risk for progression to severe COVID-19, including hospitalization or death. Patients in the authorized population who report a positive home test result from a rapid antigen diagnostic test or a positive PCR test to their provider are eligible for Paxlovid under the EUA. Confirmation of a positive home rapid antigen diagnostic test with additional direct SARS-CoV-2 viral testing, such as a PCR, is not required. Antibody tests are not considered to be direct SARS-CoV-2 viral tests.

Additional Resources:

  • To order Paxlovid from the Ohio Department of Health:

Reminder: Funding Opportunity for COVID-19 Vaccine Administration to Uninsured Individuals
The Ohio Department of Health (ODH) announced a new funding opportunity for COVID-19 vaccine providers in Ohio. This is intended to reimburse the costs of administering COVID-19 vaccines to uninsured individuals.

Before April 5, 2022, the Health Resources & Services Administration (HRSA) accepted claims for COVID-19 vaccine administration reimbursement to providers who vaccinated uninsured individuals. The HRSA program stopped accepting claims on April 5 due to insufficient funds. The Centers for Disease Control and Prevention’s COVID-19 Vaccination Program requires providers to continue administering COVID-19 vaccines at no out-of-pocket cost to recipients. As a result, some providers may be negatively impacted without reimbursement for these costs.

ODH is responding to this important need for providers to receive reimbursement to continue providing COVID-19 vaccines. Ohio COVID-19 vaccine providers who previously received reimbursement for vaccine administration through the HRSA COVID-19 Uninsured Program may apply for funding. Applicants shall not seek reimbursement through any other source for vaccines administered with this funding. Click here to download the Application for Uninsured Vaccine Administration Reimbursement. Downloaded applications will need to be signed, then emailed to Procurement@odh.ohio.gov.

The total funding available through ODH will be $1.7 million, which will be available through June 30, 2023, or until the available funds are exhausted. Funding will be awarded on a first-come, first-served basis. Vaccine providers will receive the money upfront based on the provider’s estimated number of vaccinations of uninsured individuals from the date of award through June 30, 2023. Providers will have the option of payment by electronic fund transfer or by check. Providers will be required as part of the agreement to submit quarterly reports with a total number of vaccinations of uninsured individuals to be reviewed and validated by ODH. Providers will be required to return any funding received in excess of the actual vaccines administered. Please submit any questions regarding this funding opportunity to ODH by email at Procurement@odh.ohio.gov.


OPA is working diligently to facilitate communication between state decision-makers and member pharmacists. OPA has created multiple COVID-19 resources, including a COVID-19 Vaccine Information Webpage, COVID-19 Testing Hub, and COVID-19 Resources Webpage, on the OPA website www.ohiopharmacists.org under the Resources drop-down box. Please contact Myriam Shaw Ojeda, Director of Pharmacy Extension and Public Health Initiatives, for further questions at mshawojeda@ohiopharmacists.org.

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