Weekly Clinical Correspondence Pānui

Weekly Clinical Correspondence Panui - 22/7/22 Please see below clinical correspondence for the past week.

COVID-19 Care in the Community •

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The oral COVID-19 therapeutics nirmatrelvir with ritonavir (Paxlovid™) and molnupiravir (Lagevrio®) are being reclassified from prescription-only medicines to restricted medicines, enabling pharmacists to supply to those who meet Pharmac’s criteria. It is anticipated this change will come into effect from 28 July 2022. Te Whatu Ora will send out invitations to participating pharmacists shortly to join online training on Tuesday 26 July at 7.30pm9.30pm about these changes.

From today, 18 July 2022, access to COVID-19 therapeutics has been widened. It now includes all people aged 75 years and over, and those who have been admitted previously to an intensive care unit as a direct result of COVID-19. The factors Māori and Pacific Peoples are required to have to access these antiviral treatments have also been reduced. Full access criteria can be found here.

Last week, the Government announced that people at a higher risk of acute respiratory illness from COVID-19 who meet Pharmac’s therapeutics criteria are now able to get a prescription from their doctor for COVID-19 medicines before they get COVID-19. This means the prescription is ready to use if they become unwell. Advance supply is not available via a pharmacy.

COVID-19 vaccinations • • •

Information about eligibility for second boosters with Novavax and AstraZeneca has been updated on the Ministry of Health website.

Two new videos promoting flu vaccinations to Pacific peoples have been published by the Ministry of Health.

Te Whatu Ora/Health New Zealand sent a reminder last week to health and disability providers about how to get reimbursed via the Health Provider Requests claim portal for the costs of flu vaccinations for eligible staff and about organising workplace vaccinations. For more information, email help@imms.min.health.nz or phone 0800 223987.

COVID-19 Response •

Anyone in Aotearoa New Zealand can get free rapid antigen tests (RATs) after the Government significantly expanded eligibility last week with people no longer required to have COVID-19 symptoms or live with a case. Free RATs can be ordered through requestrats.covid19.health.nz and picked up from community collection sites. People can also collect free masks from community collection sites around the motu – information on the nearest site to collect free RATs and masks is on Healthpoint.

Invitation - Building the future of health •

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He tono ā-ipurangi tēnei kia hono mai koe ki te pae kōrero nei mō ngā kaunekenga o te whakahoutanga o te pūnaha hauora Aotearoa. We warmly welcome you to join our upcoming hui with Riana Manuel, Chief Executive Te Aka Whai Ora - Māori Health Authority and Fepulea’i Margie Apa, Chief Executive Te Whatu Ora - Health New Zealand.

Tuesday 26 July, 11.45am - 12.30pm, Link: https://myevents.nz/HealthNZ/buildingthefutureofhealth2

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If you’d like to review the previous hui on 14 June you can find it here: Chief Executives' Virtual Hui 14 June 2022

Advance Prescriptions for Oral COVID-19 Antiviral Medicines – Attached guidance in Practice News.

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The document provides initial guidance to support safe and timely access to oral therapeutics for COVID-19 to reduce the risk of hospitalisation and poor outcomes.

Specifically, it clarifies a process whereby an authorised prescriber can issue a prescription in advance to a higher risk person who will meet the eligibility criteria set by Pharmac, if they get COVID-19 in the future. Whilst the antiviral medicines cannot be dispensed unless the person develops COVID-19, providing the advance prescription means that if the person develops COVID-19, they will have fewer steps to complete to fill the prescription and access the medicine. In addition, advanced scripts can provide assurance to someone at high risk that they will be able to access these medications when needed.

This is part of a suite of changes aimed at improving equity and timeliness of access to COVID-19 antivirals, including widening the Pharmac access criteria (implemented 18 July 2022), and re-classifying nirmatrelvir with ritonavir (Paxlovid™) and molnupiravir (Lagevrio®) from “prescription only” to “restricted”, or “pharmacist-only” medicines. Further information and guidance to support this reclassification will be provided separately in the near future, and we will work to update the current published information and guidance for health practitioners to align with these changes.

ESR looking for general practice participation •

ESR are currently looking for general practices to participate in community sentinel respiratory virus surveillance. Participation will involve swabbing a small number of patients with influenza-like illness weekly and sending swabs to ESR’s National Influenza Centre for testing. We use this information about respiratory virus activity in New Zealand to support public health decision making and action. If you are interested in participating or finding out more information, please get in touch with the ESR Health Intelligence Team at influenza.surveillance@esr.cri.nz

Pharmac Update: Primary Care Prescribers for the week ending 22 July 2022 – attached in Practice News is Panui with full details • • • • • • • • • • • • • • •

Lorazepam 1 mg tablets: Supply issue Accuretic (quinapril and hydrochlorothiazide) tablets: Supply issue We want you! Expressions of Interest for Pharmac’s Advisory Committees COVID-19: Information for prescribers COVID-19 antiviral Access Criteria assessment tool Olsalazine 250 mg and 500 mg capsule (Dipentum): Supply issue Ipratropium nebuliser (500 mcg/2 ml): Supply issue Progesterone cap 100 mg: supply issue Risedronate tab 35 mg: Supply issue Gentamicin sulphate (Genoptic) eye drops 0.3%: Discontinuation Macrogol eye drops (Systane Unit Dose): supply issue Levomepromazine (Nozinan) injections: Supply issue Oestradiol (Estradot) patches: Supply issue Celecoxib 100 mg capsules: Supply issue Nutricia foods products: Supply issue affecting multiple products

TB risk of Ukrainian arrivals – UPDATED guidance • • • •

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780 visas have been approved and 213 people have arrived As part of the policy setting, all health requirements for entering New Zealand have been waived for this visa A funded referral pathway for Chest X-rays is currently being explored and an up-to-date communication with this information will be released at the earliest possible time.

In the meantime, all Ukrainian arrivals over the age of 11 should be referred to the public system for chest X-ray screening due to the high incidence of tuberculosis in the Ukrainian population. Ukrainian arrivals with symptoms may have active TB and should be referred with high priority.

Chest X-rays can be arranged through DHB chest X-ray referral and the following should be annotated on the form: “Chest X-ray to exclude TB infection: high risk patient – recently arrived Ukrainian Refugee (eligible for publicly funded healthcare in NZ)”