Nirmatrelvir and ritonavir (Paxlovid®) and molnupiravir (Lagevrio®) for COVID-19 – amended PBS listing

Key Points

From 1 March 2024, the PBS eligibility criteria changed for COVID-19 oral antiviral medicines – nirmatrelvir and ritonavir (Paxlovid®) and molnupiravir (Lagevrio®).
Patients aged 50 to 69 years with COVID-19 are required to have two or more risk factors for severe disease to access PBS-subsidised treatment with nirmatrelvir and ritonavir.¹ The change to eligibility for nirmatrelvir and ritonavir was based on advice from the independent and expert Pharmaceutical Benefits Advisory Committee (PBAC)1 given reduced cost-effectiveness of nirmatrelvir and ritonavir in this lower risk population.
Molnupiravir can now only be prescribed on the PBS when nirmatrelvir and ritonavir combination is contraindicated. The details/reasons for contraindications to nirmatrelvir and ritonavir must be documented in the patient’s medical record.² The change to molnupiravir eligibility was based on PBAC advice that the nirmatrelvir and ritonavir combination is a more effective treatment than molnupiravir. However, molnupiravir may be an appropriate treatment for patients for whom nirmatrelvir and ritonavir is contraindicated.
The nirmatrelvir and ritonavir combination and molnupiravir, remain listed on the General Schedule (Schedule 85) of the PBS as Authority Required (Streamlined). The listing is for patient groups with COVID-19 who are at high risk of progressing to severe disease requiring hospitalisation.

^{Paxlovid® (nirmatrelvir and ritonavir) Pharmaceutical Benefits Scheme. Canberra: Australian Government Department of Health and Aged Care; 2024 Available from:}^{https://www.pbs.gov.au/medicine/item/12996B 13147Y}^{(accessed 6 June 2024).}
^{Lagevrio® (molnupiravir) Pharmaceutical Benefits Scheme. Canberra: Australian Government Department of Health and Aged Care; 2024. Available from:}^{https://www.pbs.gov.au/medicine/item/12910L-13144T}^{(accessed 6 June 2024).}