COVID-19 and MS

ANTI-VIRAL MEDICATIONS

There are two approved COVID-19 oral anti-viral treatments, Paxlovid® and Lagevrio®, that are listed on the Pharmaceutical Benefits Scheme (PBS) Australia. To access these medications, you need a prescription from a GP or Nurse Practitioner. Treatment with anti-viral medications needs to begin within five days of symptoms starting or a positive COVID-19 test result.

OLDER AUSTRALIANS AND FIRST NATIONS PEOPLE

If you test positive for COVID-19, you may be eligible for free anti-viral treatments under the PBS if you are:

• 70 years of age or older, regardless of risk factors and with or without symptoms, or
• 50 years of age or older with two or more risk factors for developing severe disease, or
• First Nations people, 30 years of age or older and have one risk factor for developing severe disease, or
• 18 years of age and are moderately to severely immunocompromised or have been previously hospitalised due to COVID-19 and are now re-infected.

The PBS has a list of risk factors (conditions) that contribute to their definition of high risk for developing of severe disease:

• living in residential aged care
• living with disability with multiple conditions and/or frailty (but not limited to living in supported accommodation)
• neurological conditions like stroke or dementia and demyelinating conditions, for example, multiple sclerosis, Guillain-Barre Syndrome chronic respiratory conditions including COPD, moderate or severe asthma
• respiratory compromise, including COPD, moderate or severe asthma (required inhaled steroids), and bronchiectasis, or caused by neurological or musculoskeletal disease
• obesity
• diabetes (type I or II requiring medication)
• heart failure, coronary artery disease, cardiomyopathies
• kidney impairment
• liver cirrhosis
• living remotely with reduced access to higher level healthcare

People who are considered moderately to severely immunocompromised include those with:

1. Any primary or acquire immunodeficiencies including:

• blood cancer or some red blood cell disorders (thalassemia, sickle cell disease)
• organ or stem cell transplant recipients
  primary or acquired (HIV/AIDS) immunodeficiencies

2. Any significantly immunocompromising condition where, in the last 3 months, the patient has received:

• chemotherapy or whole-body radiotherapy
• high dose corticosteroids for at least 14 days or pulse corticosteroid therapy
  treatments that deplete or inhibit B cell or T cell function
• selected conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs)

3. Any significantly immunocompromising condition(s) where, in the last 12 months the person has received anti-CD20 monoclonal antibody treatment.

4. Cerebral palsy, Down Syndrome, and congenital heart disease.

5. Living with disability with multiple conditions and/or frailty.

See below for more information, including the full list of risk factors

• Fact sheet – Paxlovid®
• Fact sheet – Lagevrio®
• Department of Health and Aged Care – Updated eligibility for oral COVID-19 treatments

OTHER TREATMENTS

In addition to Paxlovid® and Lagevrio®, the Therapeutic Goods Administration (TGA) has approved remdesivir (Veklury®) to treat COVID-19 people who are at least 4 weeks old who weigh at least 3 kg, have pneumonia and need additional oxygen. Veklury® is also approved to treat COVID-19 in people aged at least 12 years who weigh at least 40kg, who do not need additional oxygen but are at high risk of developing severe COVID-19.

The TGA has also provisionally approved the following treatments for COVID-19:

• Regdanvimab (Regkirona®): a monoclonal antibody treatment for adults with mild to moderate COVID-19.
• Tocilizumab (Actemra®): a monoclonal antibody treatment for hospitalised adults who are receiving systemic (whole-body) corticosteroids and need additional oxygen or mechanical help with breathing.
• Casirivimab+imdevimab (Ronapreve®): a monoclonal antibody treatment for people aged 12 years and older who weigh at least 40 kg, who do not need additional oxygen and who are at increased risk of developing severe COVID-19. Ronapreve® is also provisionally approved for preventing COVID-19 in people aged 12 years and older, weigh at least 40 kg patients, who have been exposed to the COVID-19 virus but have not been vaccinated against COVID-19 OR who have a medical condition making them unlikely be protected by the vaccine.

NOTE: Veklury®, Regkirona®, Actemra® and Ronapreve® are not currently subsidised through the PBS to treat COVID-19. This means people who are prescribed these treatments would need to pay the full cost for them.

If you are living with MS and concerned about COVID-19, we recommend speaking with your healthcare provider about the most up-to-date options for prevention and treatment.

Watch some specialist MS healthcare workers talk about MS and COVID-19 preventative medications and antiviral treatments – here.

Past ATAGI COVID-19 statements can be accessed here.

The Australian government released a National COVID-19 Health Management Plan for 2023 which can be accessed here.