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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)
These changes provide greater 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.
Find more information about the PBAC's latest recommendations and outcomes.
Antiviral treatments taken as capsules or tablets may help stop COVID-19 infection from becoming severe. You must start courses of these antiviral treatments soon as possible after symptoms from COVID-19 begin.
People at higher risk of severe illness are eligible for antiviral treatments. We encourage you to have an early discussion with your GP or nurse practitioner about:
- whether an oral antiviral suits your health needs
- developing a COVID-19 plan if you test positive to COVID-19.
Learn more about oral antiviral treatments for COVID-19.
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 additional risk factor/s 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
- past COVID-19 infection episode resulting in hospitalisation.
People aged 18 years or older
If you test positive for COVID-19, you may be eligible for antiviral treatments if you are:
- re-infected and have previously been in hospital from COVID-19
- 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/li>
- 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.
Who should not have antiviral COVID-19 treatments?
If you are pregnant or breastfeeding you should not have oral COVID-19 treatments. Instead, ensure you are up to date with your COVID-19 vaccinations.
If you have severe kidney or liver disease you should not have Paxlovid® COVID-19 treatment. Talk to your healthcare provider about alternative oral treatments.
COVID-19 treatments and fertility
Oral antiviral treatment may affect how prescribed birth control (the pill) works. Consider using extra contraception as the treatment may affect the pill’s effectiveness.
We recommend women use effective forms of contraception:
- during treatment and for 4 days after with Lagevrio®
- during treatment and for 7 days after with Paxlovid®.
Men should also consider using contraception during and for 3 months after taking Lagevrio®.
Talk to your healthcare provider about contraceptives and what is best for your situation.