Molnupiravir access criteria

Molnupiravir access criteria molnupiravir as at 15 August 2023

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:

1. Patient has confirmed (or probable) symptomatic COVID-19, or has symptoms consistent with COVID-19 and is a household contact of a positive case;
   AND
   
   
2. Patient’s symptoms started within the last 5 days;
   AND
   
   
3. Patient does not require supplemental oxygen^#;
   AND
   
   
4. Nirmatrelvir with ritonavir has been considered for the patient, including but not limited to using the Liverpool COVID-19 Drug Interaction Tracker(external link), and is unable to be used for clinical reasons;
   AND
   
   
5. Remdesivir is unable to be accessed;
   AND 
   
   
6. ANY of the following:
   1. Patient 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
   2. Patient has Down syndrome; or
   3. Patient has sickle cell disease; or
   4. Patient has had a previous admission to Critical Care or High Dependency care directly as a result of COVID-19; or
   5. Patient is aged 65 years or over; or
   6. Patient is Māori or Pacific ethnicity AND aged 50 years or over; or
   7. Patient is aged 50 years or over AND has not completed a primary course^ of COVID-19 vaccination; or 
   8. Patient has any combination of three or more high risk medical conditions for severe illness from COVID-19 identified by the Ministry of Health**;
      AND
      
      
7. Not to be used with other COVID-19 antiviral treatments.

Notes:

* As per Ministry of Health criteria of ‘severe immunocompromise’ (external link)for third primary dose of COVID-19 vaccine

** People with high-risk medical conditions(external link) identified by the Ministry of Health

^ ‘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 patients with chronic resting hypoxia

Accessing supply of molnupiravir 

Access to molnupiravir will continue under the current arrangements. Prescribers must endorse prescriptions, confirming that the person meets the access criteria.

Molnupiravir is supplied to pharmacies and Te Whatu Ora - Health New Zealand hospitals at no cost, as stock has been purchased directly by Pharmac.

Molnupiravir will continue to be listed in Section B and Part II Section H of the Pharmaceutical Schedule. Molnupiravir is available to order by community pharmacies and Te Whatu Ora hospitals. This process is being managed by Te Whatu Ora. 

COVID-19: Advice for all health professionals - Te Whatu Ora website(external link).

Supply to community pharmacies is managed through one wholesaler, ProPharma, and Te Whatu Ora hospitals can order from OneLink as required.

The XPharm rule applies to these treatments in the community. Community pharmacies are not able to claim subsidy through usual claiming systems as Pharmac has purchased these medicines directly.

Pharmacies will be reimbursed for their services by COVID-19 Care in the Community funding through Te Whatu Ora. Information regarding the claiming mechanism for this payment to pharmacies will be available from Te Whatu Ora. 

Who to contact

If you have any questions about these access criteria, email enquiry@pharmac.govt.nz