‘A positive step’: oral antivirals confirmed for Doctor’s Bag

GPs can now access the two PBS-listed oral COVID-19 antiviral treatments through the Prescriber Bag.
 
The decision, which applies to both molnupiravir (sold as Lagevrio) and nirmatrelvir and ritonavir (sold as Paxlovid), came into effect on 1 November.
 
GPs and other prescribers, including nurse practitioners, can order up to two 40-capsule bottles of molnupiravir as well as two cartons of nirmatrelvir and ritonavir (with 30 tablets per carton) from a community pharmacy for dispensing.
 
The treatments can only be obtained once a month.
 
‘This change is being made to support prompt treatment of patients at high risk of developing severe disease when it is not possible to obtain supply from a community pharmacy on a PBS prescription in a timely manner,’ a new PBS fact sheet states.
 
The Prescriber Bag arrangement – also known as the Doctor’s Bag – is usually intended for emergency scenarios.
 
The PBS fact sheet says that the oral antivirals are included for use in the Prescriber Bag ‘in urgent circumstances’ for patients at risk of severe disease.
 
It gives the examples of a patient in a rural or remote area where a community pharmacy may be closed, as well as a patient in an aged care or disability care facility where a timely PBS prescription may not be possible.
 
RACGP Vice President Dr Bruce Willett, who has been part of wider RACGP advocacy for the oral antivirals to be part of the Doctor’s Bag, described the move as a ‘really positive step’ which will help protect those most vulnerable to severe COVID-19.
 
‘GPs know this is sensible,’ he told newsGP. ‘It is a practical and patient-centred solution and will help those most at-risk get access to these treatments in a timely way, which is essential for them to have the most impact.’
 
The antivirals are recommended to be taken by eligible patients with mild-to-moderate COVID-19 within five days of symptom onset.
 
The push to have the COVID-19 oral antiviral treatments included in the Prescriber Bag involved extensive correspondence and lobbying by the college to the Pharmaceutical Benefits Advisory Committee (PBAC), which ultimately recommended the treatments be added.
 
Their recommendation subsequently needed to be approved at Federal Government level before being put into place.
 
Both COVID-19 oral antivirals became available on the PBS earlier this year, with molnupiravir listed in March and nirmatrelvir and ritonavir listed from the beginning of May.
 
The RACGP’s COVID-19 resources includes information on the pandemic, including treatments, relevant for every state and territory.
 
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COVID-19 oral antivirals PBAC PBS Prescriber Bag