Pfizer's new oral antiviral treatment for COVID-19, Paxlovid is available for those who need it, including those who are immunocompromised or have comorbidities that put them at risk of severe COVID-19.
Under the terms of the agreement, New Zealand will receive 60,000 treatment courses of Paxlovid this year.
Read PHARMAC's media release.
A face-to-face consultation is not needed unless the clinician feels it is indicated.
Checks and considerations when prescribing Paxlovid:
- check whether the patient meets the Pharmac access criteria (see below)
- check whether the patient wishes for active intervention.
- check for potential drug interactions and review any contraindications.
- review renal function. The prescriber should record the patient's most recent renal function (if available) on the prescription.
- manage any necessary dose adjustments of medication. Communicate this clearly to the patient. Document details in notes.
- the dispensing pharmacist will also be undertaking a medication review.
- specific information is required on prescription:
- endorse that the person meets access criteria
- document the date of symptom onset
- record latest eGFR
- provide a contact phone number.
- the contact number provided to the pharmacist needs to support easy access or urgent queries regarding medication management. Due to the tight timelines involved, prescribers and practices are asked to prioritise calls from the pharmacists.
- issue the prescription and send electronically to the local participating pharmacy.
What happens next?
- active case management will include regular review and management of clinical progress.
- check for adverse effects and send report of these to CARM.
- audit of prescription, including eligibility criteria and outcomes is encouraged.
Access criteria for Paxlovid
The access criteria for Paxlovid have been developed with the advice of Pharmac's clinical expert advisors and have been designed to help support prescribers to target available supply to those most in need and most likely to benefit. Read more.
There is currently no private supply. Prescriptions for off-label use or patients who do not meet eligibility criteria, will not be able to be dispensed.
Approvals are valid for patients where the prescribing clinician confirms the patient meets the following criteria and has endorsed the prescription accordingly:
All of the following:
- Patient has confirmed (or probable) symptomatic COVID-19; and
- Patient's symptoms started within the last five days; and
- Patient is immunocompromised and not expected to reliably mount an adequate immune response to COVID-19 vaccination or SARS-CoV-2 infection, regardless of vaccination status; or
- Patient has at least five of the following:
- Any combination of the risk factors for severe COVID-19 disease identified by the Ministry of Health (with each individual condition counting as one risk factor)
- Maori or any Pacific ethnicity
- Patient is aged 65 years and over, or is 50 years and over and has not completed a full course of vaccination, and
- Patient does not require supplemental oxygen (to maintain oxygen saturation >93%); or
- Patient does not require supplemental oxygen to maintain oxygen saturations at or above baseline (for patients with chronic resting hypoxia); and
- Not to be used in conjunction with other oral COVID-19 antiviral treatments
Read more in the Ministry's document: Information and guidance for the health sector: Paxlovid oral therapeutic for COVID-19 community treatment.