Eligibility for oral COVID-19 treatments
Changes to the Pharmaceutical Benefits Scheme (PBS) eligibility criteria for the oral treatments Lagevrio® (molnupiravir) and Paxlovid® (nirmatrelvir and ritonavir) took effect on:
- 11 July 2022
- 1 November 2022
- 1 January 2023
- 1 April 2023 and 1 July 2023 (for Paxlovid, only)
- 1 March 2024
These changes provide access for people who are vulnerable to severe disease.
The current eligibility criteria for Paxlovid and Lagevrio reflect the evidence submitted to the Pharmaceutical Benefits Advisory Committee (PBAC) to date. The PBAC is an independent, expert body appointed by the Australian Government, and its members include doctors, health professionals, health economists and consumer representatives.
The government relies on advice from the PBAC before changes are made to PBS listings. Under the law, there is no provision for the subsidised supply of a PBS-listed item outside the terms of its restrictions.
Find more information about the PBAC's latest recommendations and outcomes.
If an individual tests positive for COVID-19 and are at higher risk of severe illness they may be eligible to receive the PBS subsidised supply of the COVID-19 antivirals through the PBS. This includes:
Older Australians and First Nations people
If you test positive for COVID-19, you may be eligible for antiviral treatments if you are:
- 70 years of age or older, regardless of risk factors and with or without symptoms.
- 50 years of age or older with two additional risk factors for developing severe disease
- First Nations people, 30 years of age or older and with one additional risk factor for developing severe disease.
Risk factors include:
- living in residential aged care
- living with disability with multiple conditions and/or frailty (but not limited to living in supported accommodation)
- neurological conditions like stroke or dementia and demyelinating conditions, for example, multiple sclerosis, Guillain-Barre Syndrome
- chronic respiratory conditions including COPD, moderate or severe asthma
- obesity or diabetes (type I or II requiring medication)
- heart failure, coronary artery disease, cardiomyopathies
- kidney failure or cirrhosis
- living remotely with reduced access to higher level healthcare
People aged 18 years or older
If you test positive for COVID-19, you may be eligible for antiviral treatments if you:
- have previously been hospitalized from COVID-19 and are re-infected
- are moderately to severely immunocompromised.
Conditions include:
- blood cancer or some red blood cell disorders (thalassemia, sickle cell disease)
- transplant recipient
- primary or acquired (HIV) immunodeficiency
- chemotherapy or whole-body radiotherapy in the last 3 months
- high dose corticosteroids or pulse corticosteroid therapy in the last 3 months
- immunosuppressive treatments in the last 3 months
- anti-CD20 monoclonal antibody treatment in the last 12 months
- cerebral palsy or Down Syndrome
- congenital heart disease
- living with disability with multiple conditions and/or frailty.
View the Lagevrio® and Paxlovid® fact sheets on the PBS website for the full list of risk factors.
Find more information about the PBAC's latest recommendations and outcomes.