NICE publishes final draft guidance recommending three COVID-19 treatments

The National Institute for Health and Care Excellence (NICE) has published final draft guidance recommending three COVID-19 treatments for those at the highest risk of developing severe disease.

This includes those who are immunosuppressed, or who have other conditions such as heart disease, respiratory disease, diabetes or neurological disorders.

The agency’s latest guidance recommends the use of Pfizer’s Paxlovid (tirmatrelvir plus ritonavir), GSK’s Xevudy (sotrovimab) and Roche’s RoActemra (tocilizumab).

Paxlovid has been recommended for adults who do not need supplemental oxygen for COVID-19 and are at an increased risk for progression to severe disease, while Xevudy is recommended for the same group in cases where Paxlovid is contraindicated or unsuitable.

RoActemra is recommended for adults who are having systemic corticosteroids and need supplemental oxygen or mechanical ventilation.

Although the majority of the clinical evidence that is available for NICE to review is based on studies done before the emergence of the Omicron variant, the three treatments are recommended because they have shown promise in treating COVID-19 and are also cost-effective.

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-19 treatments outside 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 guidance comes just days after NICE said it was not recommending AstraZeneca’s Evusheld (tixagevimab and cilgavimab) for the prevention of COVID-19 in vulnerable adults who are unlikely to have an adequate immune response to vaccination, or who cannot be vaccinated.

In new draft guidance, NICE explained that there is not enough evidence of the drug’s effectiveness against current SARS-CoV-2 variants in the UK and those likely to be circulating in the next six months.

It also said that it is currently developing a new review process to update its recommendations for COVID-19 treatments. This will enable treatments to be made available to patients more quickly if they show promise in protecting against new variants and are found to be cost-effective. A public consultation on proposals for the new rapid update process will be launched on 3 April.