Labor MP calls for own government to widen Covid anti-viral eligibility in Australia

A Labor MP and doctor says the nation’s strategy on responding to Covid infections is “letting Australians down” and is calling for a major overhaul on eligibility for powerful anti-viral drugs to allow far greater access for more people.

Dr Michelle Ananda-Rajah said she paid more than $1,100 from her own pocket this week on a private script for Covid anti-virals for a sick family member who was not eligible for subsidised access to the drugs. She called on her own government to open the treatments to all people aged over 12, labelling current rules “daft”.

“I feel like Australians are being short-changed,” Ananda-Rajah, an infectious disease specialist and general physician before entering politics, told Guardian Australia.

“We’re wholesale letting down Australians. There’s no getting away from this. We’ve got nothing but telling people to take a Panadol and pray.”

But Dr Danielle McMullen, the vice-president of the Australian Medical Association, said she backed current eligibility criteria and the approach of the Pharmaceutical Benefits Advisory Committee (PBAC), noting a balance of factors around benefits and risk. She said however the rapidly evolving data on Covid necessitated constant reevaluation.

“Our strong message is if you’re eligible, get access to medications and make a pre-emptive plan,” she said.

Mark Morgan, a professor of general practice at Bond University and spokesperson for the Royal Australian College of General Practitioners, said Australia shouldn’t “take our eye off the ball” with Covid but also urged caution in changing eligibility rules.

“It would be quite wrong to recommend anti-virals beyond what the evidence shows is effective. If you start using them in people that have little to gain, you’re more likely to get a net harm than a net benefit,” he said.

“The decision needs to be made on the basis of evidence, not guesswork. I don’t want to be an armchair expert.”

Covid anti-viral drugs Lagevrio and Paxlovid are available at a subsidised price on the Pharmaceutical Benefits Scheme (PBS) for people over 18 who are moderately to severely immunocompromised. The drugs, taken to reduce Covid symptoms after infection, are also available subsidised for all people aged over 70, people over 50 with two additional risk factors or who have been previously hospitalised with Covid, as well as for First Nations people over 30 with one risk factor or previous hospitalisation.

But Ananda-Rajah, a vocal critic of the former Coalition government’s Covid response and a former doctor at Melbourne’s Alfred Health, said those eligibility rules should be dramatically widened.

“I would like us to align with the United States, where it is available for anyone 12 years and up,” she said.

“I don’t think that’s a big ask. We don’t have much in the arsenal against Covid and long Covid implications.”

Based on emerging evidence, some experts hope the use of anti-virals may help reduce the risk of long Covid.

One American study published in November, a pre-print article which has not been peer approved, analysed medical records of 56,000 patients from the US veterans’ health system; researchers reported that those who were given Paxlovid shortly after their diagnosis were 26% less likely to experience long-term Covid symptoms than those who didn’t take the drug.

However researchers also noted limitations in the study’s data, including that the majority of the research cohort were white and male, limiting the ability to generalise about results.

The health minister, Mark Butler, said the government took advice from the PBAC on drugs to be accessed at PBS prices, and noted Labor had already taken a “then-unprecedented” decision to ask the advisory committee to widen eligibility earlier this year.

“When making their recommendation, PBAC balance[s] clinical effectiveness and cost effectiveness,” Butler told Guardian Australia.

“PBAC is constantly monitoring the emerging evidence about the effectiveness of these antivirals. If evidence emerges to suggest that eligibility or eligibility criteria should be revisited, I am confident they would revisit their advice.”

He said general patients accessing anti-virals on the PBS paid $30 for a general script or $7.30 for concessions.

Butler said it was “clear we need to develop a focused national response” to long Covid and looked forward to receiving the inquiry’s report.

The Coalition’s shadow health minister, Anne Ruston, called on the government to reevaluate eligibility settings.

“If expanding the eligibility of Covid antivirals keeps more Australians out of hospital and prevent instances of serious disease, helping to take some of the pressure off our hardworking healthcare professionals, it must be considered,” she said.