How Much Does COVID Antiviral Pill Paxlovid Cost With and Without Insurance?
Paxlovid is an oral antiviral medication designed for mild-to-moderate COVID-19 in patients at high risk of progressing to severe disease. It’s a combination of two drugs, nirmatrelvir and ritonavir, which work together to prevent the virus from replicating. The U.S. Food and Drug Administration (FDA) fully approved Paxlovid for adult use in 2023, and it remains under Emergency Use Authorization (EUA) for ages 12–17 who weigh at least 88 pounds.
Although new variants keep emerging, Paxlovid continues to show strong efficacy against them. Because it targets an internal protein of the virus rather than the spike protein, it’s less impacted by mutations that often reduce vaccine or antibody effectiveness.
Pricing and Availability in 2025
Paxlovid used to be distributed at no cost by the federal government, and there are still programs ensuring low- or no-cost access in 2025. Here are the current pricing and coverage details:
| Coverage/Program | Cost to Patient | Key Notes |
|---|---|---|
| Medicare / Medicaid | $0 (free) | Covered by the U.S. government’s agreement with Pfizer through 2025. No copay or out-of-pocket cost. |
| Uninsured / Underinsured | $0 (free) | Eligible patients can access Pfizer’s Patient Assistance Program (PAP). Many pharmacies and clinics honor this. |
| Private Insurance | Typically $0 co-pay | Pfizer’s “PAXCESS” co-pay program covers up to $1,500. Most insurers treat Paxlovid like other covered prescription drugs. |
| Paying Cash (No PAP/Insurance) | ~$1,300–$1,570 for a 5-day course | This is the list price. Highly recommended to seek PAP if uninsured to avoid paying out of pocket. |
The U.S. Department of Health & Human Services (HHS) offers a Therapeutics Locator online to find pharmacies that carry Paxlovid. Pfizer also maintains details about its Patient Assistance Program, which you can use if you’re uninsured or underinsured.
Bottom line: Most people still pay nothing for Paxlovid in 2025. If you run into a high cost at the pharmacy, ask about assistance programs or try an in-network pharmacy for your insurance plan.
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David Burke, PharmD, is a seasoned clinical pharmacist with over 10 years of experience in hospital and community pharmacy settings. He earned his Doctor of Pharmacy degree from the University of North Carolina at Chapel Hill.