COVID-19 antivirals: Access Criteria
Access criteria current as at 1 October 2023
On this page
Medicine availability in New Zealand
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.
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:
- Person has confirmed (or probable) symptomatic COVID-19, or has symptoms consistent with COVID-19 and is a household contact of a positive case;
- Person’s symptoms started within the last 5 days (if considering nirmatrelvir with ritonavir) or within the last 7 days (if considering remdesivir);
- Person does not require supplemental oxygen as a result of their COVID-19 infection#;
- ANY of the following:
- Person is aged 65 years or over; or
- Person is Māori or Pacific ethnicity AND aged 50 years or over; or
- Person is aged 50 years or over AND has not completed a primary course^ of COVID-19 vaccination; or
- Person is immunocompromised* and not expected to reliably mount an adequate immune response to COVID-19 vaccination or SARS-CoV-2 infection, regardless of vaccination status; or
- Person has had a previous admission to Critical Care or High Dependency care directly as a result of COVID-19; or
- Person has Down syndrome; or
- Person has sickle cell disease; or
- Person receives Disability Support Services funded by Whaikaha - Ministry of Disabled People (previously Ministry of Health); or
- Person has pre-existing high risk due to a health condition and needs direct family, whānau or external disability care most days; or
- Person has pre-existing severe frailty and/or vulnerability due to one or more severe health conditions**; or
- Person has any combination of three or more high-risk factors for severe illness from COVID-19***;
- Not to be used with other COVID-19 antiviral treatments.
* 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.
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)
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
|Māori or Pacific
|Completed primary course
|Not Completed primary course
|Completed primary course
|Not Completed primary course
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 Pharmac’s 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.
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 Manatū Hauora (Ministry of Health) website(external link).
Pharmacists can now 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.
Read the Te Whatu Ora media release(external link) about this change or talk to your pharmacist for more details.
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(external link) and linked to 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 Te Whatu Ora - Health New Zealand hospitals at no cost, as they have been purchased directly by Te Pātaka Whaioranga - Pharmac. 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 Te Whatu Ora hospitals. This process is managed by Te Whatu Ora.
Supply to community pharmacies is currently managed through one wholesaler, ProPharma and Te Whatu Ora 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 Te Pātaka Whaioranga - 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 Te Whatu Ora. Information regarding the claiming mechanism for this payment to pharmacies isavailable from Te Whatu Ora.
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 Te Whatu Ora hospitals through OneLink. Wholesale stock is held and distributed to Te Whatu Ora hospitals by OneLink in Auckland.
Level 1 hospitals can order and administer remdesivir. Te Whatu Ora hospitals are able to provide remdesivir to both inpatients and outpatients.
Te Whatu Ora hospitals will not be invoiced for supply because this stock has been purchased directly by Te Pātaka Whaioranga - Pharmac.