COVID-19 antivirals: Access Criteria

Access criteria current as at 1 October 2023

On this page

Medicine availability in New Zealand

How to get antivirals - link)

Nirmatrelvir with ritonavir (Paxlovid): currently available

Remdesivir (Veklury): currently available

Molnupiravir (Lageviro): no longer available

These criteria are being continually reviewed and updates will be considered as evidence is updated. Always check criteria before prescribing.

Check the COVID-19 treatment portfolio page for the latest information on availability and distribution.

Rural PSO oral antivirals

Paxlovid (nirmatrelvir with ritonavir) can be ordered on rural PSO.

Schedule rule for rural PSO

Access criteria for nirmatrelvir with ritonavir and remdesivir

Access criteria – from any relevant practitioner.

Approvals are valid for people where the prescriber confirms the person meets the following criteria and has endorsed the prescription accordingly:

All of the following:


Identifying people who are severely immunocompromised as per list hosted on the Pharmac website

** Health conditions that include severe or very advanced disease including, but not limited to, severe neurological, cardiovascular, renal and respiratory conditions

*** High risk factors for severe illness from COVID-19 as per list of hosted on Pharmac website

^ ‘primary course’ defined as receiving at least two courses of vaccination against COVID-19

# supplemental oxygen to maintain oxygen saturation >93%, or at or above baseline, for people with chronic resting hypoxia due to COVID-19 infection (excluding people with chronic resting hypoxia as a result of conditions other than COVID-19).

How to interpret the access criteria

We have developed an online tool to help you assess whether your patient is eligible for funded COVID-19 antiviral treatments.

Access criteria assessment tool

We have updated the heat maps to help healthcare professionals interpret criterion 4.11 of the access criteria and identify eligible patients. 

We will continue to monitor the evidence as it becomes available, as well as available supply and update the criteria as required. 

Heat maps to identify eligible patients under criteria 4.11 for for nirmatrelvir with ritonavir (Paxlovid) and remdesivir (Veklury)

The following table gives this information non-visually. But the tool is probably more easily navigated by screen reader..

Table representation of the heat maps, showing numbers of high-risk medical conditions needed in criteria 4.11

less than 50
between 50 and 64
over 65
Māori or Pacific Completed primary course 3 0 0
Not Completed primary course 3 0 0
Other ethnicities Completed primary course 3 3 0
Not Completed primary course 3 0 0

The 3 required high-risk conditions could include multiple conditions which affect the same organ system or conditions affecting different organ systems.

People who meet one of criteria 4.4 to 4.10, do not need to have  any added high risk medical conditions. Below are some example scenarios for eligibility:

Examples are based on the high risk medical conditions listed on our website as of 1 October 2023. These risk factors may change over time. Please refer this page for the most up-to-date high risk medical conditions. 

Example 1: Person is Māori, aged 52 years old and has completed a primary course of vaccination.
This person meets criterion 4.2. If they meet the other criteria, then they are eligible for treatment. 

Example 2: Person is of European ethnicity aged 64 years old, has completed a primary course of vaccination and has diabetes, a chronic lung condition, and a BMI over 35.
This person has three risk conditions (as on the Pharmac website) and therefore meets criterion 4.11. If they meet the other criteria, then they are eligible for treatment. 

Example 3: Person is aged 35 years old, has completed a primary course of vaccination and has a very advanced neurological condition which has resulted in severe frailty.
This person meets criterion 4.10 If they meet the other criteria, then they are eligible for treatment. 

Example 4: Person is aged 40 years old, has cerebral palsy and requires care from whānau five days a week.
This person meets criterion 4.9 If they meet the other criteria, then they are eligible for treatment. 

Information for people with COVID-19

If you have, or suspect you have, COVID-19 and are at high risk of developing severe illness from COVID-19:

  • test early
  • contact your health care provider.

They are best placed to let you know what your treatment options are. Treatments must be started within short timeframes from onset of symptoms. You can find more information on the Ministry of Health (Mānatu Hauora) website(external link)

Pharmacists can dispense funded Paxlovid without a prescription. You will still need a clinical assessment. These medicines may not be right for everyone, even if you meet Pharmac’s eligibility criteria.

Accessing supply of antiviral treatments

Access to antiviral treatments will continue under the current arrangements that are in place. 

The antiviral COVID-19 treatments are not accessed by a standard Special Authority. Instead, prescriptions must be endorsed by the prescriber confirming that the patient meets the Access Criteria. The Access Criteria will continue to be available on Pharmac’s website and linked to on Health Pathways. This approach allows us to easily make changes to the criteria if required in a timely manner. 

Antiviral treatments are supplied to pharmacies and Health New Zealand | Te Whatu Ora hospitals at no cost, as they have been purchased directly by Pharmac - Te Pātaka Whaioranga. Since 1 July 2024 COVID-19 treatments have been funded from New Zealand’s annual budget for  medicines (the Combined Pharmaceutical Budget). 

Nirmatrelvir with ritonavir

Nirmatrelvir with ritonavir continues to be listed in Section B and Part II Section H of the Pharmaceutical Schedule. 

Supply of nirmatrelvir with ritonavir is currently available to order by community pharmacies and Health NZ hospitals. This process is managed by Health NZ.  

Supply to community pharmacies is currently managed through one wholesaler, ProPharma and Health NZ hospitals can order from OneLink as required. More deliveries will continue to arrive throughout 2023. The XPharm rule applies to these treatments in the community as Pharmac has purchased these medicines directly. Community pharmacies are not able to claim subsidy through normal claiming systems as alternative funding arrangements have been established. 

Nirmatrelvir with ritonavir has been purchased directly by Pharmac and there will be no standard dispensing fee. Pharmacies will be reimbursed by COVID-19 Care in the Community funding through Health NZ. Information regarding the claiming mechanism for this payment to pharmacies is available from Health NZ. 


Remdesivir will continue to be listed in Part II Section H of the Pharmaceutical Schedule. 

Supply of remdesivir will continue as it is now and is available to order by Health NZ hospitals through OneLink. Wholesale stock is held and distributed to Health NZ hospitals by OneLink in Auckland. 

Level 1 hospitals can order and administer remdesivir. Health NZ hospitals are able to provide remdesivir to both inpatients and outpatients. 

Health NZ hospitals will not be invoiced for supply because this stock has been purchased directly by Pharmac.   

More information

COVID-19 treatment portfolio (includes distribution and stock availability)(external link) 

Decision to simplify Access Criteria for antiviral COVID-19 treatments (September 2022)

Schedule listing for nirmatrelvir with ritonavir (Paxlovid)(external link)