The latest PBAC decision expands Paxlovid eligibility to Australians aged 50 years and older, with at least one additional risk factor.
PBAC has elected to allow another chunk of the population access to covid oral antiviral drugs nirmatrelvir and ritonavir (Paxlovid, Pfizer), but only while current stocks last.
The latest tranche of PBAC out-of-session recommendations green-lit a change to the PBS patient eligibility for the medicine, allowing access for people aged 50 to 59 with mild or moderate covid and one risk factor for severe illness.
Risk factors include conditions like COPD, asthma, obesity, diabetes, heart failure, kidney failure, multiple sclerosis, dementia and stroke.
People who have been hospitalised by a previous covid infection, live in a remote area with little access to secondary or tertiary healthcare, have a disability or live in residential care are also considered to have an additional risk factor.
There is, however, a catch attached to Friday’s recommendation.
“The PBAC considered that the listing will be cost-effective in the expanded population for so long as pharmaceutical benefits dispensed are sourced from the stock already purchased by the Commonwealth, and which might otherwise expire unused,” the committee said.
“As such, the PBAC recommended that this expansion of patient eligibility only apply until the Commonwealth purchased stock is exhausted or has expired.”
The last update to patient eligibility for Paxlovid was made back in March, when it was expanded to include people aged 60 to 69 who had a risk factor for severe illness.
The March update was made to a considerably larger amount of fanfare; so far, 50-and-over announcement only appears on the PBAC recommendations and has not been announced by Health Minister Mark Butler or the Department of Health itself.
To be effective, patients must begin oral antiviral treatment within five days of symptom onset.
There is also an existing exemption to the telehealth established-relationship rule for patients who have not seen their GP in person for 12 months, but who meet the PBS requirements for antivirals and are seeking a referral to a private pathologist for a covid PCR test.
In practical terms, this means that people aged 50 or over can now access an MBS-funded telehealth appointment with their regular GP – even if they haven’t seen them face-to-face in over a year – but only if they are getting a referral for a PCR test.
The PCR test, in turn, can confirm whether the person has covid and therefore whether they are eligible for antivirals.
These telehealth arrangements will end in December this year.
