Prescriptions for Covid19 anti-virals

Contacted our ICB again ref. getting the anti-viral Paxlovid to take on holiday abroad (ie without having tested positive for Covid). Integrated Care boards were set up last year in each Region and are now responsible for dealing with all Covid-related vaccination/anti-virals etc.
The call handler was very sympathetic and understood my enquiry. I wanted to be ‘prepared’ whilst on holiday just in case I catch Covid while away. I’ve now received the ‘official’ reply:
“Further to your enquiry re obtaining Paxlovid, we have received the following advice from our Vaccinations Team and clinicians at [my local ICB] who prescribe the covid19 antiviral treatments:
Unfortunately Paxlovid is only available on the NHS for patients who test positive for covid19 and have other conditions. Paxlovid has many side effects and isn’t suitable for everyone, so it must be prescribed by someone who has some specialist knowledge in prescribing these type of medicines. Our specialist service does not offer private prescriptions for patients and we are unable to advise where you may be able to obtain these privately.”
My experience in being assessed for Paxlovid does not indicate there is any particular specialism involved when getting the prescription via the ICB. They do not have access to clinical records at the hospital/GP practice - just ask a few questions over the phone! Surely my haemotologist Consultant would be suitably qualified to prescribe - especially since I’ve received x2 prescriptions in the past, when I did contract Covid in the UK, and had no side-effects!
The UK Government purchased several million courses of Paxlovid in 2021. NICE guidelines were updated in March 2023 about how these are now seen as ‘business as normal’ for prescribing. Antiviral treatments for COVID-19 - Community Pharmacy England
It seems that the problem of prescription/supply lies with very low payments to pharmacies for administering prescriptions and the lines of risk/responsibility for prescribing. This leaves the ICBs (formerly CMDUs) being gatekeepers of the drugs and cutting out GPs and hospital consultants. Presumably many of these boxes of Paxlovid, stockpiled in 2021, will be nearing their ‘use-by’ date and be destroyed.
This is what has happened to the LFTs. I took two boxes of LFTs, supplied to me last year via the ‘Test and trace’ online service to the pharmacy to be destroyed as they’re past their ‘use by’ date, in exchange for a new box (having proved my eligibility)!!
Can BCUK raise the issue of anti-virals at a higher level in the hope that NICE, pharmacies and the ICBs will develop a more sensible policy/strategy to get these drugs to the people who may benefit from them through prescription by GPs and hospital consultants (like with many other valuable drugs people may need to have an ‘emergency supply’ of when they go on holiday).

I will copy your post to Blood Cancer UK for you.

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Hi @beverleyanny,

Thank you for your post.

It’s really understandable to want to be fully prepared when travelling abroad, and to be concerned about accessing anti-viral treatment if you were to contract COVID whilst on holiday.

I have raised this issue with our Support Services Nurses and Policy Team who have advised that it is currently important, when being prescribed Paxlovid, that a clinical assessment is carried out at the time the treatment is needed. Assessing someone after they have tested positive for COVID means that blood cancer symptoms and side effects of existing treatments can be taken into account, ensuring the treatment is safe for the person and reducing the risk of adverse side-effects.

You may find the information about ‘Covid medicines and travelling’ on our travel tips webpage useful, if you haven’t seen it before. It explains that some people may be able to access treatments like Paxlovid in the country they’re travelling to.

You’re right to raise the issues people with blood cancer have experienced in accessing Paxlovid. I can see this is something my colleagues have messaged about before and that you’ve kindly shared you experience of. Our policy team remain in touch with ICBs and NHS England about improving Paxlovid access in England, and personal stories can really help with this work.

I hope the information above helps. But, if we can be of any more help, you’d be very welcome to call the support line on 0808 2080 888 to discuss things in more detail with one of the Support Services Nurses.

Kind regards,

Support Services Manager


Thankyou so much for your helpful reply @TomBloodCancerUK
I do understand the importance of assessment ref. Paxlovid and I know about the potential drug-drug interactions/possible side-effects. It still seems unusual to me that a patient’s consultant or GP is not in a better position to undertake these assessments, rather than someone who only asks the patient a few questions on the phone without access to any medical records!?
I’ve read the travel tips webpage which I hadn’t seen before and as a result have done a bit more research finding that Paxlovid may well be available in Spain where I’ll be spending most of my holiday.
Once again, thankyou to the Blood Cancer UK team for maintaining this active Forum - I find it most helpful both for information exchange and feeling part of a ‘community’.


Hi @beverleyanny,

Thanks for your reply. You’re very welcome! It’s great to hear that information is helpful and that you’re enjoying being an active member of the forum.

The way Paxlovid is prescribed is different to most medicines, and this came about for a number of reasons, including the need to avoid putting more pressure on existing NHS services during the pandemic. The current guidelines are that services distributing Paxlovid must operate 7 days a week, ensuring eligible patients can assess treatment within 48hs of testing positive for Covid. So on a practical level, it would be very difficult for GPs and consultants to manage this.

Paxlovid can also be difficult to prescribe due to it’s potential side-effects and interactions with other medicines, so it is currently deemed outside the competency of most GPs. The British Medical Association have some information around this aimed at health care professionals, which explains things a a bit more detail: bma-gp-prescribing-guidance-for-covid-antivirals-june-2023.pdf

It may be that the way patients can access COVID treatments like Paxlovid changes over time, and we’ll make sure to keep our antibodies and antiviral treatments webpage up-to-date with the latest guidance: Antibody and antiviral treatments for people with blood cancer | Blood Cancer UK

Kind regards,