Covid anti-virals: do Cunard offer them to Covid + pax and what is the cost?

[lahore]

Hello.  I was reading a post from someone on the line we usually travel with (Oceania) and evidently they supply Paxlovid to anyone who tests positive.  We will be going on our first, trial, Cunard cruise in a few weeks (Melb-Melb, Australian waters).  

Does anyone who is currently onboard or recently disembarked happen to know whether the Cunard medical centre supplies Paxlovid or any other COVID antiviral to those who test positive, and if so how much it costs? 

Context for those who are interested:  I have just had Covid for the second time (despite being 4x vaccinated) so i should be OK but my partner didn’t get it.  I noticed that the antivirals had a price of over $1000 on the packet, although being covered by the Aus PBS we only paid <$10.  Although it’s difficult to get a packet in advance, we are thinking of trying if it’s either not available, or costing over a thousand bucks on the ship.  

Any actual experience would be good to know about.  TIA

[Host Hattie]

This previous thread might help with whether they are available. 

 

 

 

 

[lahore]

Thanks @Host Hattie, it is useful but it’s a few months ago now and also it doesn’t mention to cost.  I would love to get an answer to that part of the question too.  

[exlondoner]

It was $900 in July.

[LittleFish1976]

44 minutes ago, exlondoner said:

It was $900 in July.

 

Can I ask if that was the cost on the ship for someone who had tested positive? And I am assuming that would be in USD?

[exlondoner]

39 minutes ago, LittleFish1976 said:

 

Can I ask if that was the cost on the ship for someone who had tested positive? And I am assuming that would be in USD?

Yes, we had both tested positive. I had quite a lengthy conversation with the doctor about my husband having them, as he is quite old and vaguely diabetic ie it is easily controlled by diet. She would have given them, but reckoned they weren’t necessary as being fully vaccinated is such good protection anyway against getting it badly. Furthermore he would have had to stop other medication which we all reckoned was a greater risk than severe Covid. So he didn’t have them and was fine. But the price was 900 US dollars for a five day course. My GP friend tell me this is about a 50% mark up on what it costs.

[LittleFish1976]

2 minutes ago, exlondoner said:

Yes, we had both tested positive. I had quite a lengthy conversation with the doctor about my husband having them, as he is quite old and vaguely diabetic ie it is easily controlled by diet. She would have given them, but reckoned they weren’t necessary as being fully vaccinated is such good protection anyway against getting it badly. Furthermore he would have had to stop other medication which we all reckoned was a greater risk than severe Covid. So he didn’t have them and was fine. But the price was 900 US dollars for a five day course. My GP friend tell me this is about a 50% mark up on what it costs.

 

That's very interesting. Thanks for your answer and I'm glad you and your husband both managed to fight it off successfully. Can I also ask, if a UK citizen tests positive at home I assume the NHS would supply the anti-virals gratis or at least at a minimal cost?

 

I read recently of a passenger's experience on a Princess ship (in Australian waters) who was given Paxlovid without charge. I assume that is their protocol, at least on that particular ship. I'm curious as to the differences between lines and ships. If the medications are not subsidised by any particular government for on-board use then some cruise lines must be subsidising them. At US$900 per course it will pay for people from some countries to pay their local charge, at home, in their own currency and carry them on board with them.

 

 

 

[exlondoner]

7 minutes ago, LittleFish1976 said:

 

That's very interesting. Thanks for your answer and I'm glad you and your husband both managed to fight it off successfully. Can I also ask, if a UK citizen tests positive at home I assume the NHS would supply the anti-virals gratis or at least at a minimal cost?

 

I read recently of a passenger's experience on a Princess ship (in Australian waters) who was given Paxlovid without charge. I assume that is their protocol, at least on that particular ship. I'm curious as to the differences between lines and ships. If the medications are not subsidised by any particular government for on-board use then some cruise lines must be subsidising them. At US$900 per course it will pay for people from some countries to pay their local charge, at home, in their own currency and carry them on board with them.

 

 

 

 

It would be free here on the NHS, if you were eligible for it. Eligibility is very limited, basically to people with severely compromised immunity. My husband would certainly not have been eligible.

 

 

[Underwatr]

It would also be free in the US (at least for the time being). COVID has been the US's initial toe-dip into fully socialized medicine but now that the urgency is dying down so is the appetite for government to foot the bill.
Ah, well. It was nice when the doctor said "we recommend this treatment" to be able to consider the treatment without immediately also considering the out-of-pocket cost. Only a few more months and I become eligible for Medicare, which can also be structured (with supplemental insurance) to be essentially zero out-of-pocket, at least for the services which Medicare covers.

[frankp01]

3 hours ago, Underwatr said:

It would also be free in the US

I can confirm that, at the moment, *is* free in the States. I asked my doctor if he'd prescribe a 5-day course, just 'in case'. We have a 3-week voyage, so I'm carrying on a course of Paxlovid. Which had no out-of-pocket cost. I don't know if that's due to the feds subsidizing it, or due to my prescription plan.

[Underwatr]

Good to know. I wasn't sure it would be possible to get a prescription for it "just in case."

I had a mild case in May (fever broke within 12 hours of me testing positive) but still rebounded after having taken Paxlovid, so don't be surprised if that happens. I'd expect it to recur 10-14 days after your first positive test.

[frankp01]

I don't plan on using it unless I have a pretty bad case. I guess, the problem is, not having had it (yet), I don't know how to judge what 'bad' is. I have one friend and two acquaintances who have caught COVID. My friend said it was no worse than a bad cold. Since you can start a course of Paxlovid up to 5 days after being tested positive, I'll wait and see how mine progresses. If I don't get any sicker than feeling like I have a cold, I won't bother with the paxlovid. I'm also carrying two week's worth of cold and flu medicine that I'll use, instead.

[Covepointcruiser]

I hope your “just in case” prescription from your doctor came with all the warning about this drug including all the medications you must stop for at least two weeks during and after taking your last Paxlovid.

[lahore]

16 hours ago, exlondoner said:

It was $900 in July.

Thank you.  That’s the specific information I was after.  So presuming that’s in USD, it’s definitely worth our while trying to bring some with us. 

[lahore]

Just to add to the general conversation, COVID antivirals are covered by PBS in Australia so cost us $6.80.  

Generally Australians are prescribed Lagevrio not Paxolovid, which is another reason for wanting to take it with us:  as @Covepointcruisersaid, there are a lot of drug interactions with Paxlovid which would make it risky to take for my partner.  

The Australian government has strict rules about who can have it, and you have to have symptoms before you can get it.  This will require a ‘carefully structured’ talk with our doctor if we seek to take some with us ‘just in case’.  

Given that COVID is rebounding seriously in Australia at the moment (4th wave etc., etc.) this is something we need to seriously consider.

[LittleFish1976]

20 minutes ago, lahore said:

Just to add to the general conversation, COVID antivirals are covered by PBS in Australia so cost us $6.80.  

Generally Australians are prescribed Lagevrio not Paxolovid, which is another reason for wanting to take it with us:  as @Covepointcruisersaid, there are a lot of drug interactions with Paxlovid which would make it risky to take for my partner.  

The Australian government has strict rules about who can have it, and you have to have symptoms before you can get it.  This will require a ‘carefully structured’ talk with our doctor if we seek to take some with us ‘just in case’.  

Given that COVID is rebounding seriously in Australia at the moment (4th wave etc., etc.) this is something we need to seriously consider.

 

There's also lots of Paxlovid being prescribed here in Australia, too. If you get some just in case you will pay the $1,000 AUD price - it's only on the PBS if you have been diagnosed with covid. You may already have been aware of this but I just thought I'd mention it in case you weren't.

 

[frankp01]

5 hours ago, Covepointcruiser said:

came with all the warning about this drug including all the medications you must stop for at least two weeks

Indeed. I'm on a statin, which is one of the drugs with which it interacts. But I only have to wait two days after stopping the statin. If I do test positive, I'll stop the statin, then wait and see how the symptoms progress. I was planning on delaying the paxlovid 3 or 4 days, anyway.

 

[Underwatr]

Not to get into the weeds on drug interactions, but the NIH recommended interval is during and for 2-3 days after taking Paxlovid (for those medications that they recommend stopping). It's better to take the Paxlovid when it's time and not delay it because of when you last took a statin.

[TouchstoneFeste]

15 hours ago, Underwatr said:

Good to know. I wasn't sure it would be possible to get a prescription for it "just in case."

I had a mild case in May (fever broke within 12 hours of me testing positive) but still rebounded after having taken Paxlovid, so don't be surprised if that happens. I'd expect it to recur 10-14 days after your first positive test.

 

Possible but not certain. For a recent overseas trip, I asked my doctor for a "just in case" prescription and he informed me he couldn't - he can prescribe only in the case of an actual COVID case. (This is in the US, a major health care organization.) If your own doctor can't do it, perhaps you can shop around, though.

[frankp01]

8 hours ago, Underwatr said:

It's better to take the Paxlovid when it's time and not delay it because of when you last took a statin.

That's counter to what my physician and the pharmacist suggested. They both said to wait 2 days after ceasing simvastatin.

Edited November 15, 2022 by frankp01

[lahore]

On 11/15/2022 at 12:44 PM, LittleFish1976 said:

 

There's also lots of Paxlovid being prescribed here in Australia, too. If you get some just in case you will pay the $1,000 AUD price - it's only on the PBS if you have been diagnosed with covid. You may already have been aware of this but I just thought I'd mention it in case you weren't.

 

Thanks, yes I was aware that Paxolvid is available here but local Dr’s don’t seem to be prescribing as the first choice, probably due to the interactions.  Its also interesting that all someone over 70 has to do to get a prescription is to book a Telehealth appointment and say they had a positive RAT.  I just did that myself - it was the truth, but nevertheless….

[LittleFish1976]

15 minutes ago, lahore said:

Thanks, yes I was aware that Paxolvid is available here but local Dr’s don’t seem to be prescribing as the first choice, probably due to the interactions.  Its also interesting that all someone over 70 has to do to get a prescription is to book a Telehealth appointment and say they had a positive RAT.  I just did that myself - it was the truth, but nevertheless….

Depends on the doctor and the patient, clearly! I am local and was prescribed Paxlovid. I hope whatever you have been prescribed works for you and that you recover quickly.

[rsquare]

I was also able to get a "just in case" script after substituting one of my usual drugs with one that does not interact with Paxlovid.  I also discovered that there are two versions of Paxlovid, one for most people and one for people with compromised kidney function; in the US, the boxes are printed in different colors and clearly labelled.

 

Lagevrio seems to have about a 30% effectiveness rate, which is about what you normally see with placebo in clinical trials (I used to work in the pharmaceutical industry).

[lahore]

On 11/26/2022 at 8:32 AM, rsquare said:

I was also able to get a "just in case" script after substituting one of my usual drugs with one that does not interact with Paxlovid.  I also discovered that there are two versions of Paxlovid, one for most people and one for people with compromised kidney function; in the US, the boxes are printed in different colors and clearly labelled.

 

Lagevrio seems to have about a 30% effectiveness rate, which is about what you normally see with placebo in clinical trials (I used to work in the pharmaceutical industry).

 

That’s interesting, thanks for the insight (about effectiveness and kidney issues)