The Victorian Department of Health in conjunction with RACGP Victoria are hosting a briefing for primary care practitioners tomorrow, Wednesday 21 December, 6-6.30pm. The briefing will address recent changes to advice about COVID-19 antivirals.
For anyone registering to attend that does not have an RACGP ID, please use the codes below – or use ‘000001’ for ‘other’:
Practice Managers 000000
Practice Nurses 111111
Other Practice Staff 222222
GP Liaison staff 333333
Hospital staff other 444444
Other medical professionals 000001
COVID-19 medicines – updated guidelines
Evusheld
Evusheld continues to be available in Victoria for use in high-risk people for pre-exposure prophylaxis (PrEP) of COVID-19, with all stock from the National Medical Stockpile (NMS) expiring on 31 December 2022. It is highly unlikely that further stock will be available from the NMS in 2023. Therefore, from January 2023 access will be up to individual hospitals to consider making available with a projected cost per dose of >$2500.
The Therapeutic Goods Association (TGA) announced revised dosing recommendations for the use of Evusheld - increasing the standard dose from 300mg to 600mg. Top-up doses for already treated patients is at clinician discretion. Sites can administer double dose for PrEP, however there is no guarantee that NMS stock used will be replaced as there is limited NMS stock available in Victoria.
The TGA has also provided provisional approval for Evusheld for treatment of COVID-19 indication (click here to see more in a flyer from AstraZeneca). In the absence of an alternative option for pre-exposure prophylaxis and mix of circulating variants, Evusheld continues to be available for use. Clinicians should consider this information in making individual patient management decisions. Patients should also be reminded of additional protective behaviours to prevent infection as well as the importance of early testing and their eligibility for antivirals.
A number of resources have been recently updated and will be available shortly on the department's website – these include a consumer factsheet, clinician FAQ and community prescriber guide. For further information and prescribing resources, click here.
Paxlovid
On 17 November 2022, the TGA approved a shelf life extension of Paxlovid from 18 months to 24 months. The extension may be applied retrospectively to batches manufactured prior to this approval. The storage conditions remain unchanged at ‘Store below 25 degrees Celsius’. Click here to read more from Pfizer.
Lagevrio
Acknowledging the recent updated recommendation by the National COVID-19 Clinical Evidence Taskforce that Lagevrio should not be routinely used, Victorian treatment guidelines have not changed.
When Paxlovid is unsuitable or unavailable, Lagevrio is a suitable option, as supported by an analysis conducted by the Victorian Department of Health of people aged over 70 diagnosed with COVID-19 from July to September 2022.
The department’s webpage will be updated within this new guidance shortly, in the interim please send any covid medicine queries to covid+pathways@health.vic.gov.au
The Victorian COVID-19 therapies PBS prescriber helpline is available for use by Victorian PBS prescribers such as GPs and nurse practitioners. The helpline is staffed seven days between 8-5pm and can be contacted on 03 8290 3801.
