Treatment

Treatment consists primarily of symptom relief and management of complications. For individuals with confirmed Covid-19 disease who are at high risk for a severe course, antiviral therapy and/or antibody therapy may be appropriate. Such therapies are now available for outpatients who belong to specific risk groups (see below). 
The most important measure to avoid severe courses of the disease remains vaccination.

Early therapy and preexposure prophylaxis for covid-19 patients

Persons with severely weakened immune systems have a significantly increased risk of contracting severe COVID-19. Some of these individuals do not build up sufficient immune protection despite repeated vaccination with an mRNA vaccine against SARS-CoV-2.

In Switzerland, several substances to prevent severe courses of Covid-19 are now available for this group of people:

Antibody therapy: sotrovimab (Xevudy®) as treatment and tixagevimab/cilgavimab (Evusheld) as pre-exposure prophylaxis (prevention) and also as treatment option for COVID-19.

Antiviral therapy: nirmatrelvir/ritonavir (Paxlovid®) as early therapy for SARS-CoV-2 infections.

Paxlovid® is the only directly acting oral antiviral approved in Switzerland.

Early therapy and pre-exposure prophylaxis are primarily intended for high-risk patients with a very low or absent immune response after vaccination. After careful evaluation, other patients at increased risk for severe disease progression (see SSI criteria list EN (PDF)) may also benefit from these therapies.

As per 02/13/2023:

• According to the current recommendations of the Swiss Society of Infectious Diseases (SSI), prophylactic use of monoclonal antibodies such as tixagevimab/cilgavimab (Evusheld) is currently not recommended in severely immunodeficient patients with insufficient vaccine protection against Covid 19. 
• Furthermore, the use of monoclonal antibodies, such as sotrovimab (Xevudy®) or tixagevimab/cilgavimab (Evusheld), for the treatment of Covid-19 is not currently recommended for the viral strains currently circulating in Switzerland and based on current knowledge.

In rare cases and specific situations, prophylactic treatment or therapy with these monoclonal antibodies may be considered by specialists. See also the SSI criteria list EN.

For external referrals, early therapy with paxlovid, as well as pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) is available in the outpatient clinic of internal medicine at the University Hospital Basel. 

Paxlovid® can also be prescribed by physicians and dispensed on prescription in pharmacies since the end of July 2022. For emergency dispensing on weekends, the emergency pharmacy in Petersgraben is available. The federal government will cover the cost of outpatient applications for the treatment of confirmed coronavirus disease in compliance with SSI criteria as long as these drugs are not reimbursed by mandatory health insurance. Contraindications to therapy must be strictly observed. Detailed information is compiled under:
Koordination der Versorgung mit wichtigen Covid-19-Arzneimitteln (admin.ch)

From 22.12.2022, it is now possible for self-dispensing physicians and all public pharmacies to order Paxlovid® without a prior prescription. Thus, it is possible to build up a small stock of Paxlovid® at one's own risk, as under normal conditions. It is important to note that this stockpile is not reimbursed by the federal government in case of expiration. This provides ample opportunity for patients to obtain Paxlovid® in a timely manner. Emergency deliveries of Alloga are therefore no longer reimbursed by the federal government, but are still possible - at the expense of the purchaser. We would like to draw your attention to the following facts:

With the order, the undersigned confirms that,

• Paxlovid® will only be dispensed to Swiss residents suffering from Covid-19 in accordance with the criteria of the SSI on the basis of a prescription issued by a physician who is licensed under the KVG and who is liable to pay the costs of the mandatory health insurance. Dispensing to persons not resident in Switzerland is permitted, provided that they have a prescription from a physician who is licensed in accordance with the KVG and who is active at the expense of the mandatory health insurance and who is resident in Switzerland. Prescriptions from foreign physicians or physicians who are not licensed under the KVG are not permitted.
• no prophylactic prescription or dispensing takes place.
• it has been acknowledged that the dispensing, dispatch or distribution abroad is prohibited and may be punishable under certain circumstances (cf. Art. 86 ff. HMG).
• it has been acknowledged that orders placed outside the ordering hours will incur costs for the purchaser which will not be borne by the Confederation.

Detailed information on this can also be found on the page of the FOPH Coordination of the supply of important Covid-19 medicines (admin.ch), where you will also find the following information sheets: