VEKLURY®(remdesivir) Non-Hospital Access and Purchase

This form is to request access to purchase Veklury for administration in non-hospital settings; this is not US government owned product and is not free. If approved for access, you will receive a notification from ASD Healthcare notifying you of your account, if you do not have one, and how to order Veklury


UPDATE 21Dec2022: Retail Pharmacies and Specialty Pharmacies that support Long Term Care or Skilled Nursing Facilities are now able to be approved to purchase Veklury. Please select either option as a class of trade below. If you have previously been denied access before this update, please re-enter your information below and access will be granted if you are a qualifying site.

By selecting one of these you attest to meeting the class of trade criteria.


UPDATE 22Dec2022: Generally all Outpatient pharmacy classes of trade have been granted access to Veklury. If your account does not have access and you are not a Retail or Specialty pharmacy that supports LTC or SNF sites, please choose "other" and our team will review your account for access. If you are a Retail or Specialty Pharmacy please just choose the corresponding option.

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By checking the box below, you attest and certify that (i) your organization will use the ordered therapy in a manner consistent with authorizations/approvals, (ii) your organization (or provider if an LoA is provided) will adhere to the administration requirements of Veklury, and (iii) that your selection for site class of trade/type of facility is accurate.

If you have a known or preferred ABC account, please provide to expedite the ordering and shipping process. The account number should look like 1000XXXXX or 01000XXXXX .

Please provide a copy of your state board of pharmacy license for your site, if applicable. If you do not have a BOP license, provide a copy of the state medical license for the administrating physician. If the address on the physician’s license does not match the shipping address for your site, please complete a LOA form. The license information on the form must match EXACTLY what appears on the license. For all Florida physician licenses, please complete a Declaration of Intention form. Blank LoA Form: https://drive.google.com/file/d/1ZqnEPqzXeQJ_xDIq7rN6H-ChWYsS9fY8/view?usp=sharing Florida Only, blank DOI form: https://drive.google.com/file/d/1nXG8391qnidYB55Jy2ZtBiBX3N14AQ59/view?usp=sharing Instructions to complete the LOA or DOI: https://docs.google.com/presentation/d/1mK4P5p_NN37Cwru04jXsc9l6TbTQt0oC/edit?usp=sharing&ouid=105987537352460271906&rtpof=true&sd=true

Drag and drop files here or

Note this address must match what is on the Board of Pharmacy License and our prior mAB shipping records.

Select or enter value
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Provide any shipping information (such as "attn: pharmacy).

Product Fact Sheet Links

https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/214787s005lbl.pdf

NIH Guidance for use of Veklury

https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/remdesivir/ https://www.covid19treatmentguidelines.nih.gov/therapies/statement-on-anti-sars-cov-2-mabs-and-rdv-and-omicron/

Additional Resources

https://www.nejm.org/doi/pdf/10.1056/NEJMoa2116846

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