New Zealand’s COVID-19 treatments portfolio

Pharmac is securing treatments for people with an active COVID-19 infection or at high risk of infection.

On this page

Currently available

Nirmatrelvir and ritonavir (brand name Paxlovid)

About Paxlovid and availability

Paxlovid is an oral antiviral medicine that is recommended to be started within 5 days of first symptoms. It is available for use in the community and Te Whatu Ora hospitals subject to access criteria. Paxlovid is known to cause interactions with multiple commonly prescribed medicines.

Update 5 January 2024

In December 2023 supply of Paxlovid was low, view the supply issue webpage. More stock of Paxlovid has arrived in New Zealand. The expiry of this batch of Paxlovid (nirmatrelvir 150 mg/ritonavir 100 mg), batch number GJ2963 has been extended to March 2024.

Letter to pharmacists about the shelf-life extension of Paxlovid [PDF, 165 KB]

Supply and distribution

Supply is available to community pharmacies and Te Whatu Ora Hospitals. Supply to community pharmacies is currently managed through one wholesaler, ProPharma. Te Whatu Ora Hospitals can order from Onelink as required.

This process is being managed by Manatū Hauora (Ministry of Health). More information is available on the Manatū Hauora website(external link)

Health care providers

Health care providers can find participating community pharmacies on the Community HealthPathways COVID-19 case management for adults(external link) webpage.

Note: You need a login to access

Questions

For medical questions about Paxlovid, check Pfizer's website (external link)or call Pfizer on 0800 736 363

Medsafe status

Approved under section 23 of the Medicines Act with conditions on 2 March 2022.

Paxlovid datasheet [PDF](external link)

Nirmatrelvir with ritonavir – NZ Formulary monograph(external link)

Treating COVID-19 with Paxlovid - He Ako Hiringa(external link)

Paxlovid consumer information - Health Navigator(external link) (See the resources box for translations and advice for people with kidney problems)

Schedule listing for nirmatrelvir with ritonavir(external link)

HML listing for nirmatrelvir with ritonavir(external link)

Records of the COVID-19 Treatments Advisory Group: October 2021 – May 2023

Remdesivir (brand name Veklury)

About remdesivir and availability

Remdesivir is a broad-spectrum antiviral available for use in Te Whatu Ora hospitals, subject to access criteria. Remdesivir may be used in the outpatient setting (clinics, home care visits) where appropriate with stock managed through Te Whatu Ora.

Remdesivir monograph – NZ Formulary(external link)

Supply and distribution

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

Medsafe status

Remdesivir was approved by Medsafe for the treatment of COVID-19 in New Zealand on 14 September 2023.

Advice: Remdesivir Advisory Group Record 24 September 2020 [PDF, 125 KB]

Records of the COVID-19 Treatments Advisory Group: October 2021 – May 2023

Remdesivir - Health Navigator(external link)

Treatments under review

Tocilizumab (brand name Actemra)

About tocilizumab and availability

Tocilizumab is an intravenous humanised monoclonal antibody available in Te Whatu Ora Hospitals subject to access criteria.

Not listed for use in the community.

HML listing for tocilizumab(external link)

Schedule listing for tocilizumab(external link)

COVID-19 treatment – NZ Formulary(external link)

Supply and distribution

Pharmac and the supplier continue to monitor the impact of COVID-19 on the availability of tocilizumab supply following a supply issue late 2021 to June 2022.

Tocilizumab is listed on section B of the pharmaceutical schedule as a PCT only pharmaceutical to enable use and claiming in Te Whatu Ora hospitals.

Medsafe status

Tocilizumab is Medsafe-approved for the treatment of COVID-19 in hospitalised adults who are receiving systemic corticosteroids and require supplemental oxygen or mechanical ventilation (May 2022).

Tocilizumab datasheet(external link)

Records of the COVID-19 Treatments Advisory Group: October 2021 – May 2023

Advice: Record of the Tocilizumab Advisory Group (21 April 2022) [PDF, 112 KB]

Tocilizumab for COVID-19 – Healthify website(external link)

Tixagevimab and cilgavimab (brand name Evusheld) AstraZeneca

In February 2023, Manatū Hauora (Ministry of Health) updated their clinical guidelines for use of tixagevimab and cilgavimab. They published their rationale in a position statement.

Position Statement on the use of Evusheld - Te Whatu Ora website(external link)

Available evidence indicates that tixagevimab with cilgavimab (Evusheld) is useful against a small number of the variants of COVID-19 in New Zealand. Pharmac continues to review this regularly and has not proposed changes to the access criteria at this time.

It is Pharmac’s intention that tixagevimab with cilgavimab will remain available for ordering until the stock has expired.

About Evusheld and availability

Evusheld is a combination of 2 monoclonal antibodies given as two separate and sequential intramuscular injections at different injection sites. Available in Te Whatu Ora Hospitals and the community, subject to access criteria.

Schedule listing for Evusheld(external link)

Information for patients about Evusheld - Healthify(external link)

Supply and distribution

Supply is available to order by community pharmacies and Te Whatu Ora Hospitals directly from Healthcare Logistics (HCL). Evusheld can be administered by primary care or other local solutions developed by individual districts.

The community availability of tixagevimab with cilgavimab is led by Te Whatu Ora further details of the ordering and administration process is provided in this document from Manatū Hauora(external link)

Further detail of the fees and claiming process for the administration of tixagevimab with cilgavimab in primary care can be requested from your primary health organisations or district portfolio manager.

Medsafe status

Medsafe granted provisional approval(external link) to tixagevimab with cilgavimab for pre-exposure prophylaxis of COVID-19 at the 300mg dose (150 mg of tixagevimab and 150 mg of cilgavimab).

The 600 mg dose of tixagevimab with cilgavimab is not approved by Medsafe. We understand that an application for this dose has been submitted for review. The 600 mg dose needs to be supplied under section 25 of the Medicines Act.

Application detail - Medsafe website(external link)

Records of the COVID-19 Treatments Advisory Group: October 2021 – May 2023(external link)

Advice: Record of the Tocilizumab Advisory Group (21 April 2022) [PDF, 112 KB](external link)

Evusheld for COVID-19: He Ako Hiringa Resource(external link)

Evusheld for COVID-19: Healthify website(external link)

Supply on hold

Sotrovimab (brand name Xevudy)

About sotrovimab and availability

Pharmac considered sotrovimab to treat high-risk immunocompromised people with COVID-19 infection, or those with persistent COVID-19 infection.

Based on the available evidence, Sotrovimab did not demonstrate efficacy against the COVID-19 variants circulating in New Zealand, so we didn’t secure supply of this treatment.

Medsafe status

The supplier withdrew their application to Medsafe for sotrovimab to treat COVID-19.

Casirivimab with imdevimab (brand name Ronapreve)

About Ronapreve and availability

Ronapreve was funded to treat mild to moderate COVID-19 in Te Whatu Ora hospitals. Its use was limited as available evidence indicated it was not useful against the variants of COVID-19 circulating in New Zealand.

The Ronapreve stock that was purchased by Pharmac has expired.

Medsafe status

Approved under s20 of the Medicines Act 1981.

Ronapreve datasheet [PDF](external link)

Treatments no longer available

Baricitinib (brand name Olumiant) available until end of April 2024

About baricitinib and availability

Baricitinib is a JAK 1 and 2 inhibitor used for moderate to severe illness. The stock purchased by Pharmac has been used in Te Whatu Ora hospitals subject to access criteria. It expired at the end of April 2024. Pharmac has not purchased replacement stock and baricitinib will no longer be available after current stock expires.

Supply of baricitinib was secured during Pharmac’s response to the COVID-19 pandemic to provide an alternative to tocilizumab for the treatment of moderate to severe COVID-19 in hospitalised patients. This was intended as a one-off purchase and, as supply issues with tocilizumab have been resolved, additional supply of baricitinib is not required. Tocilizumab will continue to be funded for people hospitalised with moderate to severe COVID-19.

HML listing for baricitinib(external link)

Baricitinib – NZ Formulary(external link)

Medsafe status

Baricitinib is not approved by Medsafe for use in New Zealand, meaning it would need to be prescribed and used in line with section 25 of the Medicines Act 1981.

Records of the COVID-19 Treatments Advisory Group: October 2021 – May 2023

Baricitinib for COVID-19 – Healthify website(external link)

Molnupiravir (brand name Lageviro)

Molnupiravir was previously available in New Zealand for the treatment of COVID-19. The last remaining stock secured by Pharmac expired on 31 January 2024. The decision has been made not to purchase new stock at this time. This is based on available evidence and advice from Pharmac’s COVID-19 Treatments Advisory Group.

February 2023 record of COVID-19 Treatments Advisory Group advice [PDF, 335 KB]

Records of the COVID-19 Treatments Advisory Group’s May 2023 meeting are not yet available, however, the advice received is consistent with the February 2023 recommendations.

The Manatū Hauora COVID-19 Therapeutic Technical Advisory Group (CT-TAG) published a position statement on 28 February 2023.(external link)This statement recommended against the use of molnupiravir as treatment for patients with COVID-19 who have not been admitted to hospital.

We publicly consulted on the role of molnupiravir in New Zealand, in April 2023. We decided to retain funded access to molnupiravir for a small group of people in July 2023. This was based on the consultation feedback we received. People have been able to access the remaining molnupiravir stock. As the remaining stock is expiring, molnupiravir will no longer be available in New Zealand.

Treating and managing COVID-19

Advice for health professionals on COVID-19 treatments - Health NZ | Te Whatu Ora(external link)

COVID-19 resources for the public - Healthify(external link)

Medsafe's regulatory role in the response to COVID-19(external link)

Information about prescribing and dispensing unapproved medicines - Medsafe(external link)

Medsafe's update on applications for COVID-19 treatments(external link)

The virus and treatments have evolved

Due to the changing nature of COVID-19, some of the treatments that have been developed to treat the virus over the past few years may no longer be as effective as when they were first available.

Since the pandemic began, we have had to make decisions to purchase treatments with limited amounts of evidence. To make sure New Zealanders could get treatments to protect against severe illness, we purchased a range of options, with the aim of having treatments available that are effective against all COVID-19 variants and illness severities.

We assess the efficacy of treatments using the information that is available to us at the time and considering the current environment. We continue to monitor and review the treatments that are available for COVID-19 and evidence for their efficacy.

When we first secured treatments we knew that the virus would evolve and treatments could become less effective. Taking a portfolio approach to purchasing COVID-19 treatments helps us manage this risk.

Looking for more information?

We've had to do things differently to make sure New Zealanders could get access to these medicines.

Our approach to funding COVID-19 treatments(external link)

We have released a large number of documents relating to COVID-19 medicines. Search our Official Information Act (OIA) responses for "COVID"

Official Information Act responses(external link)

Pharmac is responsible for securing medicines to treat and prevent COVID-19 for New Zealanders. Pharmac:

organises supply of the treatments
works with suppliers and the health sector and
sets the criteria for who can access the funded medicines.

If you have questions about COVID-19 medicines, email enquiry@pharmac.govt.nz

New Zealand’s COVID-19 treatments portfolio

Currently available

About Paxlovid and availability

Supply and distribution

Health care providers

Questions

Medsafe status

Read more

About remdesivir and availability

Supply and distribution

Medsafe status

Read more

Treatments under review

About tocilizumab and availability

Supply and distribution

Medsafe status

Read more

About Evusheld and availability

Supply and distribution

Medsafe status

Read more

Supply on hold

About sotrovimab and availability

Medsafe status

About Ronapreve and availability

Medsafe status

Treatments no longer available

About baricitinib and availability

Medsafe status

Read more

Treating and managing COVID-19

The virus and treatments have evolved

Looking for more information?