COVID antiviral orders doubled prior to listing on PBS

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The federal government has stepped up its support for nilmatrelvir and ritonavir oral antivirals (sold as Paxlovid) by ordering an additional 500,000 treatment courses prior to listing on the Pharmaceutical Benefits Scheme (PBS).


This means that one million courses of treatment are available. This is more than three times the amount of molnupiravir (sold as Lagevrio), another oral antiviral drug approved this year and listed on PBS.


Dr. Michael Bonning, medical director of the Inner West GP-led respiratory clinic in Balmain, Sydney, said the list of PBS was after considerable use of Nirmatrelville and Ritonavir in the COVID response.


“It has become the most commonly used oral antiviral drug for this wave of COVID, at least through hospital and community-managed medical departments and respiratory services,” said Dr. Bonning. newsGP..


“I think the recommendation to add it to PBS was very strong.”


By the time of the announcement on Saturday (April 9th) DoH reported 42,867 The oral antiviral course was already dispensed through the national medical stockpile.


Clinical trials on the use of antiviral drugs were conducted primarily among patients who were not vaccinated during the previous wave of virus when Delta was a major SARS-CoV-2 variant of concern. I was vaccinated. According to the test results, the risk of hospitalization and death for participants was reduced by 88%.


Write in Australian prescriber Last month’s journal, senior pharmacists and clinicians involved in pandemic response I said I need more understanding How oral antivirals work, taking into account the differences between clinical trials and current prescribing activity.


Although this treatment has been used among those who have been fully vaccinated in Australia, the BA.2 mutant is also currently predominant and has already affected the efficacy of another antiviral drug, sotrovimab. There is a possibilityPrompted for change last week NationalCOVID-19 Clinical Evidence Task Force Recommendations.


Dr. Khayyama Laltaf, Chair of the Elderly Care for certain stakeholders of the RACGP, said: newsGP Evidence is still emerging about the actual effectiveness of the new COVID treatment.


“We started prescribing [molnupiravir] More often, now that the number of cases of COVID is starting to increase in elderly care facilities, “he said.


“The development of new antivirals is relatively new, so it’s difficult to ensure at this stage. [of the impact].. “


However, Dr. Bonning believes that Nilmatrelvir and ritonavir have a significant impact, recognizing the differences between clinical trials and current usage.


“Through hospital stockpiling and partnerships with local virtual care services, we have seen very positive reactions from patients who personally prescribe these medicines,” he said.


“We have found that these can be very helpful to the right people who meet the criteria.


“The Pharmaceutical Benefits Advisory Board evaluates their cost-effectiveness and the usefulness prescribed by common practices and helps to significantly reduce their chances of going, so it is a cost-effective and useful drug. I came to the conclusion that there is a hospital.’


This treatment is intended for people who are at high risk of developing a more serious illness in the early stages of infection. According to DoH, these include patients diagnosed with COVID-19 within 5 days of the onset of symptoms.

 

• Over 65 years of age, with two other risk factors for severe illness
• Over 75 years with one other risk factor
• Over 50 years old, from Aboriginal or Torres Strait Islanders, there are two risk factors for severe illness.
• Moderate to severe immunodeficiency.

Dr. Bonynge said the list of PBS is likely to further expand the effects of treatment. He also emphasizes how much of the COVID response depends on primary care, adding oral antiviral prescriptions to vaccine deployment and telemedicine to identify symptoms. Said.

Treatment is Numerous contraindicationsAvailable to qualified individuals up to $ 42.50 per script, especially for other medications. If you have a concession card, you can use it for $ 6.80.

The cost of Nirmatrelville and Ritonavir in the United States is reported to be US $ 530 per course. Australia’s figures have not been confirmed, but if the costs are nearly parallel here, the total cost would be over $ 700 million.

First order 500,000 courses in Nirmatrelville and RitonavirThe treatment developed by Pfizer was announced by the federal government last October.

In the same month, DoH also confirmed an order for 300,000 courses of Merck-developed molnupiravir oral antiviral drug, which was posted on PBS earlier last month.

According to DoH, the latter treatment has been prescribed about 5000 times with PBS so far.

Regardless of the potential efficacy of antivirals, the priority remains vaccination for Dr. Altaf, and a fourth booster immunization is currently the most clinically open. Vulnerable cohort including over 65 years old..

“It has happened in the facility before [the oral antiviral] Available and vaccinated patients were very successful, “he said.

“Compared to my experience last year, older patients in elderly care facilities are much better with this illness, most of them showing some mild symptoms and recovering within a few days. I am. “

The Therapeutic Goods Department (TGA) tentatively approved two oral antivirals in January.

A Risk classification tool Released by the COVID-19 Evidence Task Force last month, it helps guide clinicians in assessing treatment options for COVID patients.

Special guide Information that GPs need to know about oral antivirals It is also published by newsGP. RACGP Created a list of COVID-19 resources Contains information related to all states and territories.

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COVID-19 (new coronavirus infection) Paxlovid PBS Pfizer Pharmaceutical benefit system

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