Community pharmacies in Scotland that provide Covid-19 antivirals to non-hospitalised high-risk patients will receive a service fee of £45 per dispensed item, the Government has said. 

The terms of service for dispensing the antivirals were set out in a circular addressed to Scottish pharmacy teams last week (13 January).

It outlined that pharmacies involved would receive a service fee of £45 per dispensed item, alongside an £8 delivery fee payable for necessary journeys up to 10 miles, and £12 for journeys above this.  

It follows the move in December 2021 to allow Covid-positive patients who have been ‘identified as being at very high risk of deterioration, hospitalisation or death from Covid-19’ access to new Covid-19 treatments from the NHS.  

Patients can directly phone a number set up by their health board to get an assessment to see if they are suitable for this treatment. 

There is ‘no expectation’ that these medicines will be prescribed in primary care ‘unless part of locally agreed service arrangements’, the circular explained. 

Treatments available 

There are currently two antibody and antiviral treatments being offered to people at high-risk of becoming seriously ill from Covid - sotrovimab and molnupiravir.  

The neutralising monoclonal antibody (nMAB) medicine, sotrovimab, has been recommended as a first treatment option for those at high-risk from Covid-19, and in most cases will be administered at hospital day clinics. 

However, if sotrovimab is not suitable, individuals may be treated with a five-day course of antiviral molnupiravir.  

According to a Scottish Government circular, community pharmacies may be involved in the distribution of molnupiravir, at the discretion of health boards.  

‘Health Boards may seek to utilise part of the community pharmacy network for the safe and effective dispensing and home delivery of molnupiravir, and any future Covid-19 antivirals, to individuals who are suitable for treatment,’ the document said. 

UK medicine regulators approved molnupiravir for patients with at least one risk factor for developing severe Covid in November.  

Treatment is currently being provided through the PANORAMIC study, run by the University of Oxford, which has recruited 10,000 patients at risk of serious illness from Covid-19 to take the antiviral treatment molnupiravir at home after receiving a positive PCR test. 

In December, PSNC highlighted the potential for community pharmacies in England to distribute Covid-19 oral antiviral treatments to patients in the future, despite pharmacies not being involved in initial plans to give access to the most vulnerable through GP practices.