OPINION 19
ausdoc . com . au 6 DECEMBER 2024
OPINION 19
Insight
I ’ ve heard from every Chicken Little
Why consider LAGEVRIO for your patients 70 + who test positive for COVID-19 ? 1 , 3
Proven
*
In MOVe-OUT , LAGEVRIO reduced the risk for hospitalisation or death vs . placebo through Day 29 by 30 % ( adjusted relative risk reduction ) in adult patients with mild to moderate COVID-19 9
( 95 % CI : 1 %, 51 %; 6.8 % ( 48 / 709 ] vs 9.7 % ( 68 / 699 ). Adjusted risk difference -3.0% ( 95 % CI -5.9%, -0.1%), p-value not available ). Based on a planned interim analysis of LAGEVRIO vs placebo : The adjusted risk difference was -6.8% ( 95 % CI : -11.3%, -2.4; 7.3 % ( 53 / 377 ) vs 14.1 % ( 28 / 385 ); p = 0.0024 ).
Real-world studies , 10-14 including the local Victorian study published in 2023 , 10 also support the use of LAGEVRIO in treating older vaccinated patients with mild to moderate COVID-19 .
Treatment-related adverse events ≥ 1 % ( MOVe-OUT , LAGEVRIO vs placebo ): 3 Diarrhoea ( 2 % vs 2 %), nausea ( 1 % vs 1 %), dizziness ( 1 % vs 1 %)
No No known drug interactions based on limited data available 3
dose adjustments required in patients with renal and / or hepatic impairment 3
▼This medicine is subject to additional monitoring in Australia . This will allow quick identification of new safety information . Healthcare professionals are asked to report any suspected adverse events at www . tga . gov . au / reporting-problems .
SELECTED SAFETY INFORMATION 3
Gerard Benedet National executive director , Pharmacy Guild of Australia .
Medical lobby groups are using fear as a weapon .
to reduce risk of hospitalisation or death 3 , 9
INDICATION : LAGEVRIO has provisional approval for the treatment of adults with COVID-19 who do not require initiation of oxygen due to COVID-19 and who are at increased risk for hospitalisation or death . The decision to approve this indication was based on efficacy and safety data from a Phase 3 trial . Continued approval of this indication depends on additional data .
CONTRAINDICATIONS : Hypersensitivity to the active substance or any of the excipients . Hypersensitivity reactions have been reported with LAGEVRIO . If signs or symptoms of a clinically significant hypersensitivity reaction occur , immediately discontinue LAGEVRIO and initiate appropriate medications and / or supportive care .
PRECAUTIONS :
Pregnancy Category D : The use of LAGEVRIO is not recommended during pregnancy . In women of childbearing potential , health care providers should discuss the chance that they may be pregnant and consider the need for a pregnancy test .
Contraception : Advise women of childbearing potential to use effective contraception for the duration of treatment and for 4 days after the last dose of LAGEVRIO . Sexually active men with a partner of childbearing potential should use contraception during and for 3 months after treatment . Based on animal data , LAGEVRIO may cause foetal harm when administered to pregnant women .
Breastfeeding : Based on the potential for adverse reactions on the infant from LAGEVRIO , breastfeeding is not recommended during treatment and for 4 days after the last dose of LAGEVRIO .
Paediatric patients : Use in patients under the age of 18 years is not recommended .
ADVERSE REACTIONS : Common : nausea , diarrhoea , dizziness . The following have been reported in post-marketing experience : hypersensitivity , angioedema , erythema , pruritus , rash , urticaria , vomiting .
Before prescribing , please review the full Product Information available at www . msdinfo . com . au / lagevriopi or by scanning the QR code .
WHILE it is often said death and taxes are life ’ s only certainties , I would argue there is another inevitability : when someone is running for an elected position in a medical lobby group , they frequently and predictably use fear as their primary weapon .
I wonder how attacking others
Copyright © 2024 Merck & Co ., Inc ., Rahway , NJ , USA and its affiliates . All rights reserved . Merck Sharp & Dohme ( Australia ) Pty Limited . Level 1 – Building A , 26 Talavera Road , Macquarie Park NSW 2113 . MSDA0152 . AU-ANV-00605 v3.0 . Issued November 2024 .
fixes the known problems in their own profession .
Attacking community pharmacists must be an attractive political wedge issue aimed at medical professionals voting in lobby group elections ; why else would you do it ? It is clearly naked internal politics at its worst . As you might imagine , in my role , I have heard just about every
Chicken Little argument around . However , they are predictable and usually go something like this : “ If pharmacists are allowed to ( fill in the blank here ), patients will be put at risk .”
Or , “ If doctors are not in control , then ( add in the unfounded and farfetched patient misadventure ).”
This fearmongering about community pharmacists ’ training
Scan to access study design for registration study 9
to administer vaccinations first began in 2014 . We have recently hit new heights . Attacking community pharmacists now features in all election candidate manifestos across the different medical lobby groups .
Maybe community pharmacists should be flattered by the constant talk .
I would offer that the talk takes up column inches and energy that would be better devoted to providing their own professions with a light-onthe-hill strategy for the future .
Community pharmacists want to see all healthcare professionals thrive , especially GPs .
There is more than enough work for everyone .
Given the constant focus on community pharmacists , one could reasonably conclude that patients ’ problems with cost and access to a GP , specialists or other healthcare professional are solved : that the GP shortage has been filled , that Australia has finally found a way out of pinching thousands and thousands of doctors from around the world and instead is producing an ever-increasing number of homegrown doctors .
Sadly , there will be more criticism of community pharmacists wanting to do more to help patients .
Despite the rhetoric , for many years , we have seen a fuller scope of practice for community pharmacists in England , Wales , Canada and New Zealand .
Time after time , these full-scope services have been evaluated and have been found to have positive health outcomes for patients , taken pressure of GPs , reduced unnecessary hospital presentations and exceeded patient need .
Against this no-plan-for-thefuture backdrop , we know that fewer medical graduates are choosing general practice .
This is compounded by the fact that , in 2023 , there were 4503 fewer GPs practising in Australia than in 2019 .
During this time , the Australian population grew by about 1.4 million .
In contrast , the number of community pharmacists is growing year on year .
Community pharmacies are the most frequently accessed health destination , with more than 444 million individual patient visits annually and 2127 pharmacies open after hours , including weekends .
As patients would expect , on the front line , community pharmacists work constructively with GPs on a daily basis . Unfortunately , as we are seeing in this current medical lobby election season , this practical support on the front line does not translate through to the rhetoric of the various candidates ’ political agendas , much less a focus on patients .
At any time , we are more than happy to sit down , talk , swap ideas and work together to build a better health system , with patient-directed care at its heart .
It is an open invitation .