Pharmac publishes experts’ advice and seeks views on patient access criteria for COVID-19 treatments

Pharmac is releasing the October meeting records of their COVID-19 clinical expert advisory group and seeking feedback on the patient access criteria for two funded COVID-19 treatments – baricitinib and casirivimab and imdevimab (branded as Ronapreve).

“To help us make decisions on which treatments to fund and who should be eligible for them, we set up a COVID-19 clinical expert advisory group,” says Dr David Hughes, Pharmac’s Chief Medical Officer. “They look at the evidence for these treatments, to help us understand how they could benefit New Zealanders.”

COVID-19 Treatments Advisory Group (records and membership)

“Today, we are releasing the records of their October meeting, where they provided advice on baricitinib, Ronapreve and another treatment, molnupiravir. The records include their recommendations for potential patient access criteria.”

“We use access criteria to ensure the medicines we fund are given to those with the highest health need and those most likely to benefit from the treatment,” says Dr Hughes. “In this consultation we are asking health professionals and stakeholders, including consumer groups, for their feedback on what we are proposing.”

Baricitinib is being proposed for use in hospital for those with moderate to severe symptoms of COVID-19, as an alternative treatment option to tocilizumab if this is not available. Baricitinib is not currently Medsafe approved for use in the treatment of COVID-19 and clinicians will need to comply with section 25 of the Medicines Act 1981.

Ronapreve is being proposed for use in hospital for patients with COVID-19 who have mild to moderate symptoms and are at high risk of progressing to severe disease. We are also proposing that it is given in the community to profoundly immunocompromised people with mild to moderate COVID-19 symptoms.

“We have secured supply of a limited volume of Ronapreve, which we estimate would be sufficient to treat up to a maximum of 12,600 patients with mild to moderate COVID-19 throughout 2022. We expect the first 5,300 courses to be available in New Zealand from January 2022, with additional stock to be delivered from April 2022.”

“There may be others in the community who would benefit from access to Ronapreve, but currently fall outside the currently proposed patient access criteria,” says Dr Hughes. We have sought further advice from the COVID-19 clinical expert advisory group about this, and we will be considering this further in the New Year.”  

“Reports show that Ronapreve is successful in treating those with the Delta variant of COVID-19. The evidence is less clear and still emerging for Omicron, but Pharmac is continuing to work as quickly as possible to assess the latest information as it becomes available, and secure access to, further treatments.”

To date, Pharmac has approved funding for tocilizumab and remdesivir, which are both already being used in our hospitals, and we have secured stock of baricitinib. Advance purchase agreements have also been negotiated for Ronapreve, molnupiravir and Pfizer’s antiviral treatment.

“Getting vaccinated is the best defence against COVID-19. For those who do become unwell with COVID-19, I want to reassure New Zealanders that Pharmac is working as quickly as possible to assess, and secure access to, treatments. We are doing this using money from the Government’s COVID-19 response relief fund rather than from the Combined Pharmaceutical Budget,” concludes Dr Hughes. 

Pronunciation guide

Baricitinib | Bara-sit-inib

Ronapreve | Ron-a-preeeve

Tocilizumab | Tossa-liz-u-mab

Remdesivir | Rem-des-evir

Molnupiravir | Mol-nu-peer-a-ver