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The National Institute for Health and Care Excellence (NICE) has confirmed its recommendation for NHS use of three treatments for COVID-19 in final guidance.
However, its final decision on three other treatments been delayed, after manufacturers lodged appeals against draft guidance, in which NICE did not recommend the drugs.
The final guidance recommends the use of Paxlovid (nirmatrelvir plus ritonavir; Pfizer) for adults with an increased risk of progression to severe COVID-19, who do not need supplementary oxygen; Xevudy (sotrovimab; GSK) for adults with an increased risk of progression to severe COVID-19, who do not need supplementary oxygen and who cannot take Paxlovid; and RoActemra (tocilizumab; Roche) for adults with COVID-19 receiving systematic corticosteroids, who need supplemental oxygen or mechanical ventilation.
NICE does not recommend Ronapreve (casirivimab plus imdevimab; Roche) for treatment of COVID-19 in adults because of a lack of evidence that it is effective at treating Omicron variants.
To ensure consistency on NHS use of COVID-19 treatments, the Scottish Medicines Consortium collaborated on the guidance, which will apply across the UK.
In draft guidance, published in February 2023, NICE did not recommend: Evusheld (tixagevimab plus cilgavimag; AstraZeneca), Lagevrio (molnupiravir; Merck Sharp & Dohme) or Veklury (remdesivir; Gilead Sciences) for treatment of acute COVID-19 owing to uncertainties over effectiveness against Omicron variants and cost-effectiveness.
Final decisions on these three drugs will be made after the manufacturers’ appeals have been heard by an independent appeal panel at the beginning of May 2023.
NICE is developing a new review process to update its recommendations on COVID-19 treatments if they show promise against new variants. It will launch a four-week public consultation on proposals for the new rapid update process on 6 April 2023.
