More support needed for rural communities to supply COVID-19 antiviral medication

Hauora Taiwhenua Rural Health Network welcomes the Government’s announcement to widen the criteria under which the COVID-19 antiviral medication, Paxlovid, can be prescribed but has concerns around safety and support available in rural communities.

It is an important step forward as we come into the next surge of COVID which will have a huge impact on health services and is already resulting in a higher number of deaths each day.

However, the decisions to allow community pharmacists to supply this medication without a prescription, and the mention of “back pocket” prescriptions, raise some serious questions regarding patient safety, which need to be adequately addressed before this becomes a reality.

Hauora Taiwhenua Rural Health Network Chair Dr Fiona Bolden says, “Community pharmacists are an essential part of our rural health care team who have already had a very positive role in helping with the care of COVID in the community.”

“Supplying this medication without the safety, support, and communication tools as well as adequate training will place additional unnecessary pressure on them.”

Paxlovid is a complex medication which has many interactions with other medications and can’t be used without a person having adequate kidney function. It can cause side effects which need explanation and management.

For Paxlovid to be safely supplied, access to this information is required and it is currently not available in a universal way across the country.

“In remote rural areas some people have had their anti-viral medication prescribed from many kilometres away and couriered to them from an urban pharmacy,” Dr Bolden says.

“This is important if we are to achieve equity in access for these medications and it also needs to be done in a context where that person can get further care for their illness if it is needed in a timely manner.”

“Clinical assessment is always going to be an essential part of managing illnesses no matter where people live. Outcomes to changes in care need to be monitored carefully for unintended consequences,” Dr Bolden says.

Hauora Taiwhenua is eager to work with Te Whatu Ora Health New Zealand and the Royal New Zealand College of General Practitioners, to ensure appropriate mechanisms are developed for the safe use of these therapeutic medicines by those in rural areas of New Zealand.