Updated eligibility guide for Covid-19 antiviral treatments

The Pharmaceutical Benefits Advisory Committee has recommended expanded eligibility criteria for COVID-19 oral antiviral treatments, Paxlovid (nirmatrelvir and ritonavir) and molnupiravir (Lagevrio). 

This will be effective from Monday 11 July 2022.

This decision is in response to the latest evidence on the effectiveness and safety of the medicines, the rate of uptake since they were made available on the PBS and the changing epidemiology of the virus.
Eligibility has been broadened to include people who have chronic respiratory issues due to conditions such as COPD, moderate or severe asthma and there is also greater access for adults living with disability who have multiple medical conditions.
Not being vaccinated has been removed as a risk factor from the criteria for prescription under the PBS.

The new eligibility includes updated age limits and risk factors summarised below. 

Older Australians and Aboriginal and Torres Strait Islander people, who test positive for COVID-19.

  • 70 years or older regardless of risk factors, and with or without symptoms
  • 50 years or older with 2 risk factors
  • Aboriginal or Torres Strait Islander, 30 years or older and with 2 risk factors.

Risk factors include:

  • living in residential aged care
  • living with disability with multiple conditions and/or frailty (but not limited to living in supported accommodation)
  • neurological conditions like stroke or dementia and demyelinating conditions e.g. multiple sclerosis, Guillain-Barre Syndrome
  • chronic respiratory conditions including COPD, moderate or severe asthma
  • obesity or diabetes (type I or II requiring medication)
  • congestive heart failure, coronary artery disease, cardiomyopathies
  • kidney failure or cirrhosis
  • living remotely with reduced access to higher level healthcare.

People aged 18 years and older who are moderately to severely immunocompromised and test positive for COVID-19.

Conditions include:

  • blood cancer or some red blood cell disorders (thalassemia, sickle cell disease)
  • transplant recipient
  • primary or acquired (HIV) immunodeficiency
  • chemotherapy or whole-body radiotherapy in the last 3 months
  • high dose corticosteroids or pulse corticosteroid therapy in the last 3 months
  • immunosuppressive treatments in the last 3 months
  • rituximab in the last 12 months
  • cerebral palsy or down syndrome
  • congenital heart disease
  • living with disability with multiple conditions and/or frailty

Additional information

Fact sheet – Paxlovid® (nirmatrelvir and ritonavir) PBS listing (July 2022)
Fact sheet – Lagevrio® (molnupiravir) PBS listing (July 2022)
Fact sheet – Changes to PBS eligibility for COVID-19 treatments – Information for prescribers and pharmacists

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