Australia

More Australians can now access COVID-19 antiviral treatments. Here’s what you need to know

More Australians are now able to access COVID-19 antiviral treatments, with the government expanding eligibility for those who are most at risk.
From Monday, all Australians aged over 70 who test positive to COVID-19
Those aged over 50 with two or more risk factors for severe disease also have access, along with Aboriginal or Torres Strait Islander people aged over 30 with two or more factors. Immunocompromised people over the age of 18 may also be eligible.

The oral treatments had previously been restricted to a smaller cohort of older Australians with high risk factors.

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The federal government said the Pharmaceutical Benefits Advisory Committee (PBAC) recommended the changes in response to the latest evidence on the effectiveness and safety of the medicines, and the changing epidemiology of COVID-19.

Experts have welcomed the change and say the medications are a useful tool in our pandemic response, but that vaccination remains the most important factor. Here’s what you need to know.

What are antivirals?

Antiviral treatments, which are taken as a tablet or capsule, help to stop COVID-19 infection from becoming severe.
Professor Steven Tong, an infectious diseases physician from the Doherty Institute in Melbourne, said antivirals are medications that target the SARS-COV-2 virus and stop it from either replicating or from making the proteins needed to survive and cause infections.
“Neither of the [listed] treatments have really been shown to reduce the symptomatology or duration of symptoms. The main effects seems to be in reducing the risk of hospitalisation or death for those at highest risk,” he told SBS News.
There are two oral medications that have been listed on the PBS this year – Paxlovid and Lagevrio. Professor Tong said large clinical trials have shown the drugs to reduce the risk of hospitalisation in high-risk patients by about 90 per cent with Paxlovid and by about 30 per cent with Lagevrio.
He said Paxlovid works to prevent the virus from producing the proteins it needs, therefore disabling the virus.
“The second drug [Lagevrio] reduces the replication of the virus in the body. So, you can imagine that if you disable a virus with a medication, it’s not going to be able to make you as sick and generally it stops it from replicating in the body,” he said.

Dr Bruce Willett, vice president of the Royal Australian College of General Practitioners (RACGP), said the treatments are particularly effective in vulnerable communities, such as elderly people and those with chronic illness and immune issues.

Who is eligible?

From Monday, the government has expanded the criteria to ensure any Australians aged over 70 who test positive to COVID-19 can access the medicines on the PBS.
Those aged over 50 with two or more risk factors for severe disease also have access, along with Aboriginal or Torres Strait Islander people aged over 30 with two or more factors.
Immunocompromised people over the age of 18 may be eligible while adults living with a disability who have multiple medical conditions will also have greater access.
The government has expanded the risk factor list to include a broader range of chronic respiratory issues.

Normally costing more than $1,000, the medicines will be available for $6.80 for concession card holders and around $40 for everyone else.

“COVID cases and hospitalisation numbers are climbing, particularly with the new variants,” Health Minister Mark Butler said on Sunday.
“These oral antivirals dramatically reduce the risk of severe disease, particularly for older Australians, and will help keep people out of hospital”.
The RACGP welcomed the expansion, calling it a “sound and timely decision that will make a real difference for many patients across Australia”.
“It means that more people can be protected against the effects of severe COVID-19. It will protect people and of course, as a knock-on effect, it’s going to help the hospitals and health system,” Dr Willett said.
Professor Tong said the changes are now “sufficiently broad”.

“The important thing to consider is that those trials were done in high-risk patients, so the main thing for us as a community now is to be able to identify those who are at highest risk, and to be able to offer these medications for those patients,” he said.

How and when should I access them?

Eligible Australians will need a prescription from an authorised prescriber, for example a general practitioner, in order to access these medications.
Both the government and experts say they need to be started early after testing positive.
“All the trials have been conducted in patients who’ve been symptomatic for five days or less – which means once you become symptomatic, you need to get tested quickly, getting that result as soon as possible, and then presenting to medical care within that five days of symptom onset,” Professor Tong said.
Dr Willett recommends that anyone who has a positive test result should call their doctor or a COVID-19 helpline to check if they’re eligible.
He said most prescriptions are being done via a telephone consult, and can now be sent electronically to a patient’s mobile phone or email.
“It is going to be difficult to commit to times because of the pressure on practices in terms of getting to everyone, but they’re going to be doing their best to get to everyone as soon as they possibly can to enable them to get these medications,” he said.
Dr Willett and Professor Tong both said consulting with your GP is vital, as one treatment in particular – Paxlovid – can interact with other medications.
“It’s very important to see your GP or health practitioner, who will then be able to check for all those kinds of interactions and make sure that it’s not dangerous for a patient to receive this drug,” Professor Tong said.
An advertising campaign will also be launched to educate Australians about the treatments.

The ‘Plan For COVID’ campaign encourages people to test at the first sign of symptoms, talk to their doctor without delay for advice and seek treatment options.

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How important are they?

As COVID-19 cases climb across the country, Dr Willett described antiviral treatments as an “important second line in our defence” against the virus. But he said vaccinations remain key in preventing severe disease.
“Vaccination is absolutely the first line of defence. It’s really important that people get all of the recommended vaccinations for your age group and your risk. That’s essential,” he said.
Professor Tong agrees, calling antivirals a “really useful additional tool in our toolkit”.
“The risk of severe disease continues to be significantly reduced by vaccination, even with the Omicron variants BA.4 and BA.5, which are now becoming the majority variant,” he said.
It comes as more Australians became eligible for a fourth vaccine dose and COVID antivirals from Monday.
An additional 7.4 million people will be able to receive a fourth vaccine dose, with people over 50 recommended to get the extra booster while those over 30 are also eligible.
“We still need to prioritise getting those third shots – and in many cases, the fourth shots as well – into the more elderly population and others who are at risk in our community,” Professor Tong said.
“Then these antivirals kick in after that – they provide additional incremental benefits to those who are at risk.”
When it comes to our future pandemic response, both experts said it’s too soon to tell how effective antiviral treatments might be.
Professor Tong said virus resistance will always be a risk.

“We’re going to have to keep a close eye on whether with the SARS-COV-2 virus that mutants arise as we start using these drugs more and more, and look out for resistance to that.”

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