Pharmac is securing treatments for people with an active COVID-19 infection or at high risk of infection.
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About remdesivir and availability
Remdesivir is a broad-spectrum antiviral available for use in 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.
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 is currently undergoing regulatory review by Medsafe. 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.
Baricitinib is a JAK 1 and 2 inhibitor used for moderate to severe illness. It is available for use in Te Whatu Ora hospitals subject to access criteria.
Te Whatu Ora hospitals can order supply direct from Onelink as required. Both 4 mg and 2 mg packs are available. Pharmac will continue to order additional stock to be available via Onelink as required. Hospitals will not be invoiced for supply because this stock has been purchased directly by Pharmac.
Medsafe status
Baricitinib is not approved by Medsafe for use in New Zealand, meaning it would need to be prescribed and used in accordance with section 25 of the Medicines Act 1981.
Following careful consideration of the evidence, Pharmac has tightened the access criteria for molnupiravir. The restrictions come into place on 15 August 2023. They will remain in place until stock of molnupiravir either runs out or expires. Pharmac has not purchased more molnupiravir.
Molnupiravir is an oral antiviral medicine which is recommended to be started within 5 days of first symptoms. It is currently available for use in the community and Te Whatu Ora hospitals subject to access criteria.
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.
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).
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.
Supply is available to order from participating 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.
At the end of February Manatū Hauora updated their clinical guidelines for use of tixagevimab and cilgavimab and have published their rationale in a position statement available on the Te Whatu Ora webpage, COVID-19: Advice for all health professionals.
Available evidence indicates that tixagevimab with cilgavimab (Evusheld) retains efficacy 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.
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.
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.
Ronapreve is a combination of 2 monoclonal antibodies (casirivimab and imdevimab) that is supplied as individual 20 ml multidose vials of casirivimab and imdevimab. It can be administered via intravenous infusion or subcutaneous injection and is available for use in in Te Whatu Ora hospitals subject to access criteria.
Te Whatu Ora hospitals may directly order stock of casirivimab with imdevimab from HealthCare Logistics as required. It is Pharmac’s intention that casirivimab with imdevimab will remain available for ordering until the stock has expired.
Sotrovimab is not available in New Zealand. We have been advised that the regulatory application with Medsafe for the use of sotrovimab in the treatment of COVID-19 is on hold while further evidence is collected. The future availability of sotrovimab in New Zealand would be dependent on Medsafe approval being received.
Medsafe status
Xevudy was submitted to Medsafe for consideration in late-April 2022.
Treating and managing COVID-19
The Manatū Hauora provides clinical advice for health professionals on COVID-19 treatments. Learn more:
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.
We consulted on the role of molnupiravir in our treatment portfolio. Submissions closed 2 May 2023. We are currently considering the feedback we received.
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We've had to do things differently to make sure New Zealanders could get access to these medicines.
