Paxlovid to treat COVID-19 supply agreement

OIA response

Thank you for your request dated 18 July 2023 under the Official Information Act 1982 (OIA) for information relating to (nirmatrelvir with ritonavir) Paxlovid. You requested:

It appears your paxlovid access criteria was determined in 2022 in conjunction with clinical expert advisors and other stakeholders. We know that there has been a massive increase in people with long covid over the past year. How have you worked to take a fresh look with a view to widening the criteria based on a current public health crisis associated with long covid and the severely compromised immune systems of people with long covid that struggle to fight further waves of the virus. 

What work has Pharmac done to survey the GP community about how many cases of long covid they are seeing and if they think the criteria for paxlovid needs to be widened

Provide documentation and briefing and discussion papers around the current supply agreement for Paxlovid. How many units have been ordered? How have you reviewed the supply agreement over the past year in line with supporting those with long covid

Te Whatu Ora and Pharmac have committed to continually review supply and COVID-19 case data to inform stock management, and quality control processes. As at 18 July, what is the current supply and stock. What is your projected forecasts for the stock usage? Is this being under used or over used? 

Share briefing and evidence papers for the past year for how you are supporting and continually reviewing the medical supports available for people with long covid in New Zealand 

What information do you currently hold for how many New Zealanders do you think have long covid at this time?

Long COVID

Pharmac regularly receives requests to make changes to the access criteria for COVID-19 treatments (including for Long COVID-19). We review information and evidence as it becomes available and seek advice from our COVID-19 Treatments Advisory Group as needed.

Pharmac’s COVID-19 Treatments Advisory Group (the Group) considered Long COVID-19 for the first time in February 2023. A record of the Group’s discussion is available here [PDF, 335 KB].

Long COVID-19 was considered by the Group again in May 2023. Full records of this discussion will be published on Pharmac’s website once they have been finalised. This is expected to occur in the next few weeks.

You may be aware that Pharmac has recently released a consultation on a proposal to make changes to the access criteria for COVID-19 antivirals. This includes a summary of the advice received from the Group regarding Long COVID.

We continue to monitor COVID-19 evidence and trends as they emerge. We also regularly engage with our partners across the health sector, including GPs and others from primary care regarding COVID-19 antiviral treatments, and consider changes to the access criteria based on the feedback we receive. We would welcome any information you wish to share that would assist with our consideration of COVID-19 antiviral treatments for long COVID.

Attached to this response you will find briefing papers prepared for our COVID-19 Treatments Advisory Group regarding antiviral high-risk conditions and Long COVID-19. Information we hold about the number of New Zealander’s who could have Long COVID-19 can be found in the attached briefings.

COVID-19 Treatment Advisory Group Briefing Paper [PDF, 909 KB]

Paxlovid access criteria

When the current antiviral access criteria was set in September 2022, we estimated that approximately 24% of reported cases would be eligible to receive COVID-19 antivirals. We note that there are a many factors which may impact the uptake and need for COVID-19 treatments and that these factors may also change over time. This means it is difficult to determine whether any given uptake of COVID-19 treatments is appropriate.

We meet regularly with our health sector partners including Manatū Hauora and Te Whatu Ora to monitor the use and uptake of COVID-19 antivirals. These regular reviews help to inform changes to the access criteria and other aspects of the health sector to support uptake of COVID-19 antivirals amongst eligible populations.

Paxlovid supply

We have ordered 171,048 courses of Paxlovid since March 2022. As of 31 July 2023, there are approximately 44,000 courses of Paxlovid available in New Zealand. We have attached the decision papers related to the supply of Paxlovid.

Decision paper for nirmatrelvir with ritonavir (Paxlovid) [PDF, 961 KB]

Supply forecast

Information relating to Pharmac’s forecasting of future Paxlovid stock requirements is withheld under section 9(j) of the Official Information Act 1982 (see below for further information on section 9(j) of the OIA).

Supply agreement documentation

The request to ‘provide documentation and briefing and discussion papers around the current supply agreement for Paxlovid’ is very broad and includes a large number of documents. Much of the information included in these documents would be irrelevant to the request or would need to be withheld on confidential grounds. For this reason we are declining this request under section 18(f) of the OIA. However, we are happy to discuss further refining this aspect of your request, if there is specific information you are seeking.

Withholding grounds

We have redacted a small amount of information from the documents as we consider this is necessary to:

  • protect information where the making available of the information would be likely to unreasonably prejudice the commercial position of the person who supplied or who is the subject of the information (section 9(2)(b)(ii));
  • protect information which is subject to an obligation of confidence or which any person has been or could be compelled to provide under the authority of any enactment, where the making available of the information would be likely to prejudice the supply of similar information, or information from the same source, and it is in the public interest that such information should continue to be supplied (section 9(2)(ba)(i));
  • enable Pharmac to carry on, without prejudice or disadvantage, negotiations, including commercial negotiations (section 9(2)(j)).

Summary

We trust that this information answers your queries. Please note, you have the right to make a complaint to the Ombudsman about our response to your OIA, under section 28(3) of the OIA. Details of how to make a complaint(external link) are on the Ombudsman’s website.

To make information more freely available, we publish selected OIA responses (excluding personal details) on our website. Please get in touch with us if you have any questions about this.