March 10, 2026
A new study has found that most Victorians aged 70 and over who contracted COVID-19 during the pandemic received antiviral treatment, while also highlighting differences in who received the recommended antiviral treatment.
In Australia, nirmatrelvir-ritonavir (also known as Paxlovid) is the recommended first-line oral antiviral treatment for COVID-19 for people at increased risk of severe disease while molnupiravir (also known as Lagevrio) is approved for use when nirmatrelvir-ritonavir is unable to be taken for medical reasons.
Researchers analysed COVID-19 cases among older adults in Victoria between July 2022 and April 2023, linking infection notifications with national datasets including vaccination records, prescription data, and census information. The study included 76,120 people aged 70 and older.
Overall, two-thirds (66%) of these patients received an antiviral medication. Among the 50,005 people treated, most – around 74% – were prescribed molnupiravir, while the rest received nirmatrelvir-ritonavir, the preferred antiviral treatment.
Use of nirmatrelvir-ritonavir increased over the course of the study. In July 2022, about 19% of treated patients received the medication, rising to 35% by April 2023.
The research also identified several factors associated with receiving antiviral treatment. After accounting for age and sex, older adults living in residential aged care facilities and those with higher incomes or education levels were more likely to receive antiviral treatment.
Among those treated, patients with higher socioeconomic status were more likely to receive the recommended drug, nirmatrelvir-ritonavir, rather than molnupiravir.
Surprisingly, researchers found that most patients prescribed molnupiravir did not have a medical reason preventing them from taking nirmatrelvir-ritonavir. About 68% of molnupiravir recipients had no major drug-interaction reason to avoid the preferred medication.
The findings suggest that while antiviral treatment reached many older Victorians during the study period, factors such as socioeconomic status, vaccination history, and aged-care residency may have influenced which treatments people received.
Researchers say further work is needed to understand what helps and what hinders prescribing of recommended antiviral treatments for older Australians.
Original APPRISE supported study
Edwards, L.J., Scaria, A., Cheng, A.C. et al. Patterns of use of oral antivirals for COVID-19 in people 70 years and over in Victoria, Australia: a linked data study. BMC Infect Dis 26, 408 (2026). https://doi.org/10.1186/s12879-026-12536-y