Q. My husband got COVID-19 last fall. He has had great success with Paxlovid in the past, when he got it for free during the pandemic. This time, he was charged $800 on his Medicare Drug Plan. That seems outrageous.

A. During the pandemic, the government purchased Paxlovid (nirmatrelvir + ritonavir) directly from the manufacturer and distributed it free of charge to most patients. Once COVID-19 was no longer considered a crisis, though, the government left pricing and distributing totally up to Pfizer.

Someone without health insurance might have to pay as much as $1,706 for a five-day course of treatment. That is the retail price GoodRx.com lists on its website. Using a GoodRx coupon could get that cost down to around $1,500. According to other readers who have Medicare plus private insurance, the cost could be $700 to $800 for five days of medicine. That is out of reach for many people. Pfizer has had sales of over $25 billion for Paxlovid and more than $90 billion for its COVID-19 vaccine (Comirnaty).

Q. My doctor diagnosed depression and prescribed me the antidepressant sertraline. Over time, it caused a lack of emotion and a loss of libido.

She switched me to Wellbutrin. I experienced no side effects from this drug, and my sex life returned to normal. Then the insurance company switched me to the generic bupropion. It has caused horrible side effects.

I don’t want to go back to sertraline, but a loss of libido would be better than feeling so awful. Why can’t I get the brand name at an affordable price?

A. Many readers have complained about a lack of libido and other sexual side effects while taking antidepressants such as sertraline (Zoloft), escitalopram (Lexapro) or fluoxetine (Prozac). Bupropion (Wellbutrin), on the other hand, may actually help enhance sexuality. Some people report that Wellbutrin can increase libido. Other readers have reported that some generic bupropion formulations do not work as well as the brand name Wellbutrin.

Long-acting Wellbutrin (XL 300) could cost more than $3,000 a month in the U.S. In Canada, the same brand-name antidepressant could be under $200 for three months. You can learn a lot more about the pros and cons of various antidepressants in our “eGuide to Dealing with Depression.” It discusses sexual side effects in some detail. Our “eGuide to Saving Money on Medicines” also provides details on legitimate Canadian pharmacies. Both online resources may be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. My allergist told me several years ago to use Afrin for no more than three days to avoid rebound congestion. My husband’s pharmacist recently stated that it can be safely used following a break of non-use for three days (three days on, three days off).

They were discussing using it to stop a nosebleed, since it works by constricting vessels in the nose.

It is wonderfully effective in relieving full-on congestion for sleeping, but we use it sparingly.

A. Rebound nasal congestion can occur with many nasal spray decongestants if they are used for more than several days. Intermittent use, on the other hand, is much less likely to cause that problem.

Other readers have told us that Afrin (oxymetazoline) can be effective against nosebleeds because of the vasoconstricting action of the drug. Others rely on such sprays when flying to avoid ear pain on descent. Such temporary use is unlikely to cause dependence.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”