COVID Antiviral Update

COVID-19 antivirals have broader eligibility criteria from July 11. Antivirals can reduce the risk of hospitalisation by up to 88% in those at high risk, so please read this email carefully to see if you or someone you care for may be eligible.

Eligibility.

COVID-19 positive (RAT or PCR) with symptoms < 5 days and one of the following:

What do you need to do?

Step 1. GP Telehealth appointment.

Book with your regular general practice if possible, as the GP will need to know your medical history and your regular medications and review your most recent kidney function blood tests. At YourGP, book a ‘COVID positive telehealth’ appointment type. If we are fully booked, select this appointment type on the online cancellation list. Note that you wish to discuss antiviral treatment. We will make every effort to call as we want to prioritise your accessing this medication.

Your GP will:

• check eligibility
• check your kidney function from previous blood tests (if available) to ensure it is safe to give you the full dose
• review potential interactions with your usual medications
• send an e-script to your mobile or email.

There are significant potential drug interactions with some medications. In some instances, the antiviral of first choice will not be appropriate, in which case alternatives can be selected. Or we may be able to proceed if it is possible to withhold or reduce the dose of your other medications.

Step 2. Arrange for collection/delivery of your script.

An e-script has a QR code that your pharmacy can utilise. Call your local pharmacy to check if the antiviral is in stock. Ask how they would like the e-script to be sent (text or email) and forward the QR code. The pharmacy may be able to deliver, or you can send in a non-infectious friend/family member to collect. Do not attend the pharmacy in person.

The actual cost of the antivirals is over $1000 per treatment. This is subsidised on the PBS, so that you will pay $42.50 or $6.80 (with a concession card.)

Private scripts for otherwise ineligible patients cannot be provided. Supply needs to be reserved for those at the highest risk. Studies have found antivirals to be of little benefit for those not at high risk.

Risk factors for eligibility.

• lives in residential care (aged or disability)
• living with disability with multiple conditions and/or frailty (but not limited to living in supported accommodation)
• neurological conditions, including stroke, dementia, multiple sclerosis and Guillain-Barre
• respiratory compromise, including COPD, moderate or severe asthma (required inhaled steroids), and bronchiectasis
• congestive heart failure, coronary artery disease, cardiomyopathies
• obesity (BMI greater than 30 kg/m2)
• diabetes type 1 or 2, requiring medication for glycaemic control
• renal failure (eGFR less than 60 mL/min)
• cirrhosis (liver damage)

Immunocompromised conditions include:

• Blood cancers such as leukaemia, lymphoma, myelodysplastic syndromes, multiple myeloma and other plasma cell disorders
• Post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months),
• HIV/AIDS
• Chemotherapy or whole-body radiotherapy in the last 3 months
• High-dose corticosteroids (greater than or equal to 20 mg of prednisone per day, or equivalent) for at least 14 days in a month or pulse corticosteroid therapy in the last 3 months
• Immunosuppressing medications such as (anti-CD20 antibodies, BTK inhibitors, JAK inhibitors, sphingosine 1-phosphate receptor modulators, anti-CD52 antibodies, anti-complement antibodies, anti-thymocyte globulin), mycophenolate, methotrexate (more than 0.4mg/kg/week), leflunomide, azathioprine (at least 3mg/kg/day), 6-mercaptopurine (at least 1.5mg/kg/day), cyclophosphamide, chlorambucil, cyclosporin, tacrolimus.
• Rituximab in the 12 months
• Down Syndrome
• Cerebral palsy
• Congenital heart disease
• Thalassemia
• Sickle cell disease
• Other haemoglobinopathies

If you are not eligible but have a significant medical condition that you are concerned about, please book a telehealth appointment to discuss the situation.