The National Institute of Health and Care Excellence (NICE) has recommended three treatments for Covid-19 in final draft guidance issued this week.
The guidelines mean that adults at the highest risk of developing a severe illness when infected with Covid-19 will have access to three medicines that can be taken at home or within a hospital setting.
The medicines, which NICE says are clinically effective as well as cost-effective, include Paxlovid (nirmatrelvir plus ritonavir, Pfizer), Xevudy (sotrovimab, GlaxoSmithKline) and RoActemra (tocilizumab, Roche).
Patients at the highest risk from Covid-19 complications include those who are immunosuppressed or those with chronic conditions such as heart disease, respiratory disease, diabetes, or neurological conditions.
The recommendations come after NICE was asked to look at treatments currently being used in the NHS across the UK and review them in terms of both their clinical effectiveness and their cost-effectiveness for the treatment of Covid-19 infections.
Much of the clinical evidence was collected before the emergence of the Omicron variant, but NICE have recommended Paxlovid, Xevudy and RoActemra based on the presented evidence. These drugs show ‘some evidence suggesting they are effective in treating Covid-19’. The treatments were also found to be cost-effective.
To keep pace with potentially rapidly changing Covid-19 variants, NICE has also announced that it is developing a new review process so that updates on treatment recommendations can be implemented more quickly. The public consultation on proposals for the new rapid update process will begin on 3 April.
Paxlovid is the recommended treatment for adults who do not need supplemental oxygen but have an increased risk of progressing to severe Covid-19. For patients who cannot be given Paxlovid, Xevudy is recommended meaning ‘there is something for everyone with mild Covid-19 in the community’ according to NICE.
The third drug, RoActemra, is recommended for treating Covid-19 in adults who are having systemic corticosteroids, a steroid given orally or via an injection, and need supplemental oxygen or mechanical ventilation.
Helen Knight, director of medicines evaluation at NICE, said: ‘NICE is the first health technology assessment body in the world to look at the clinical and cost-effectiveness of Covid treatments outside of their use during the pandemic.’
‘In recommending these treatments, we have been able to strike the right balance between their effectiveness and the best use of public funding as we come out of the pandemic, ensuring the NHS can continue to deliver maximum value to the taxpayer.’
The draft guidelines are now available for appeal from registered consultees, which include companies, patients and carer groups, and healthcare professionals. In the absence of any appeals, NICE expects to publish its final recommendations in March.
Until final approval of the draft guidelines, access to Covid medicines will continue to be guided by the published UK-wide clinical access policies agreed by the UK Chief Medical Officers under pandemic-specific arrangements. Once published, the final guidance will supersede these policies and determine routine NHS access for these treatments.