Decision to widen access to remdesivir for COVID-19

Medicines COVID-19 Decision

Current access criteria

As our response to the COVID-19 pandemic evolves, we are updating access criteria to treatments. 

Find the current access criteria

What we’re doing

We're pleased to announce that the access criteria for remdesivir will be temporarily updated to allow for wider access for the treatment of COVID-19. 

Widened access is effective immediately. Completed treatment notification forms from DHB hospitals are no longer required to be sent to Pharmac. Pharmac has secured additional remdesivir stock to support wider use. 

Detail about this decision

The access criteria are immediately widened for remdesivir for the treatment of COVID-19. This change in access criteria is temporary. It will be reassessed in the future, for example when other COVID-19 treatments are available in New Zealand, such as the oral antivirals. 

The new criteria target use of remdesivir to people with mild to moderate COVID-19 considered at high risk of complications from COVID-19.  

Since the initial criteria were set, further evidence has become available. Based on this evidence, the COVID-19 Treatments Advisory Group(external link) has recommended to Pharmac that remdesivir be available for those with mild to moderate COVID-19, rather than moderate to severe disease, due to the known benefits of treatment in this setting. A record of this advice is being finalised and will be publicly available soon. 

The new funding criteria are as follows:

Initial application – from any relevant practitioner.

All of the following:

  1. Patient has confirmed (or probable) symptomatic COVID-19; and
  2. Patient’s symptoms started within the last 7 days; and
  3. Any of the following:
    1. Immunocompromised individuals not expected to reliably mount an adequate immune response to COVID-19 vaccination or SARS-CoV-2 infection; or
    2. Patient is unvaccinated* and has at least one of the following: Aged 65 years or over, Māori or any Pacific ethnicity, any comorbidity as listed below**; or
    3. Patient is vaccinated* and has at least two of the following: Aged 65 years or over, Māori or any Pacific ethnicity, any comorbidity as listed below**; and
  4. Either:
    1. Patient does not require supplemental oxygen (oxygen saturation >93%); or
    2. Patient does not require supplemental oxygen at saturations no lower than baseline for patients with chronic resting hypoxia; and
  5. Not to be used in conjunction with other COVID-19 antiviral treatments; and
  6. Treatment not to exceed five days.

Notes:

Treatment may be given in an inpatient or outpatient setting

* ‘Vaccinated’ defined as having received at least two vaccine doses more than seven days earlier.

** Comorbidities associated with a higher risk of severe outcomes are: severely immunocompromised, significant cardiac disease, uncontrolled hypertension, uncontrolled diabetes, chronic lung disease, chronic kidney disease, chronic liver disease, cancer, history of smoking, BMI 40 or higher. More detail available on the Ministry of Health website(external link)

We have secured an additional 5,000 doses of remdesivir, enough to treat about 1000 people. This stock is now available and we are working to secure more. 

Remdesivir currently undergoing regulatory review by Medsafe. For more information refer to the Medsafe website for the approval status of COVID-19 treatments(external link). As remdesivir is not approved by Medsafe for use in New Zealand, it would continue to be prescribed and used in accordance with section 25 of the Medicines Act 1981.(external link) 

Accessing supply of remdesivir 

Access to remdesivir will continue as it is now. Remdesivir is currently not listed on the Pharmaceutical Schedule. 

DHB hospitals can order stock direct from Onelink. Wholesale stock is held and distributed to DHB Hospitals by Onelink in Auckland and Dunedin. DHBs will not be invoiced for supply because this stock has been purchased directly by Pharmac. 

DHB hospitals are no longer required to complete and provide a treatment notification form to Pharmac. An Access Criteria Form is available for download on our website. 

[download removed: because criteria have been updated 3 March 2022]

For more information, such as dosage and method of administration, please refer to the factsheet provided by Gilead Sciences (New Zealand) [PDF, 975 KB]. 

Distribution considerations in the community

The distribution mechanism for COVID-19 treatments in the community hasn’t been confirmed. We are working with the Ministry of Health to identify and consider available options, including the possible use of regional and local coordination hubs that are being established to support New Zealand’s response to COVID-19.  

At this stage, remdesivir will not be readily available in the community. We are working to ensure the oral antiviral treatments are available as soon as feasible to meet this need.

Level 1 hospitals are able to order and administer remdesivir and DHB Hospitals are able to provide remdesivir to both inpatients and outpatients.

If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.