As Australia experiences another rise in transmission of COVID-19, it is as important as ever to protect our most vulnerable senior Australians.
Vaccines are proven to provide the best protection against COVID-19, however there are some individuals who are at higher risk for severe disease if they become infected with COVID-19. The oral antiviral treatments, molnupiravir (Lagevrio®) and nirmatrelvir and ritonavir (Paxlovid®) can be used by adult patients in high risk groups who do not require initiation of oxygen due to COVID-19 who are at increased risk of hospitalisation or death.
COVID-19 can be very serious for adults in high-risk groups, even when they are fully vaccinated. Oral antiviral treatments can save lives.
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 Pharmaceutical Benefits Scheme (PBS) and the changing epidemiology of the virus, the independent, expert Pharmaceutical Benefits Advisory Committee (PBAC) has recommended expanded eligibility criteria for both COVID‑19 oral antiviral treatments. The Australian Government has accepted this recommendation and implemented it from Monday 11 July 2022.
All Australians aged 70 years or over who test positive to COVID-19, with or without symptoms, are able to access these oral antivirals on the PBS. Treatment should be offered to every person 70 years of age or older who tests positive for COVID-19 (regardless of setting), where clinically appropriate, within 24 hours of a positive test.
With the increased transmissibility of current COVID-19 variants, it is highly likely there will be an increase in residential aged care outbreaks and an increase in the number of residents infected. It is critical that oral treatments are accessible for every COVID positive resident 70 years of age or over.
To facilitate speedy access and best practice treatment in a residential aged care facility (RACF) setting, RACFs are encouraged to pre-assess any potentially eligible residents which should include:
- discussing consent options for potential treatment with the aged care resident and relevant decision-maker;
- identifying eligible aged care residents in RACF clinical management systems;
- discussing potential medicine administration with the aged care resident's prescriber, GP, nurse practitioner and facility clinical care staff; and
- ensuring a dispensing pathway is established with community pharmacy.
Primary care providers continue to play a pivotal role as the key contact for patient guidance on eligibility and risk factors and prescribing the best treatment where clinically appropriate.
Treatment should be commenced as soon as possible after a diagnosis of COVID-19 and within 5 days of symptom onset (or, for asymptomatic adults 70 years of age or older, as soon as possible after diagnosis by RAT or PCR is confirmed). Older people receiving oral antiviral treatments should be closely monitored for side effects.
