The latest on Evusheld, a COVID-19 preventative treatment

In this blog we explain what we know about the preventative COVID-19 treatment, Evusheld, and answer some of the most common questions we have received from patients.

Page last updated: 5th May 2023

As of October 2022, Evusheld is available to buy privately in the UK. Read more about this below.

What is Evusheld? 

Evusheld is a preventative treatment, also known as a pre-exposure prophylaxis. This means it is given to patients before they are exposed to COVID-19 in order to prevent them from contracting the virus if they are exposed to it. For most people, the best way to prevent infection is vaccination. Evusheld is intended for use in adults who are unlikely to mount an immune response from COVID-19 vaccination, for example for those who are immunosuppressed.

Evusheld is the combination of two long-lasting antibodies: tixagevimab and cilgavimab. It works by binding to the spike protein on the outside of the SARS-CoV-2 virus, the virus that causes COVID-19. This in turn prevents the virus from attaching to and entering human cells.

On 17th March 2022 Evusheld was approved by the Medicines and Healthcare products Regulatory Agency (MHRA). However, this approval did not mean that Evusheld would become available to patients (see below).

Will I have access to Evusheld and if so, when? 

Approval by the MHRA is a decision that states whether a drug is safe and effective, after which the company is granted a licence to sell the treatment in the UK. This usually makes a drug available from a private healthcare provider, but the pharmaceutical company was saving stocks for the NHS at first. However, the MHRA licence did not mean the treatment was automatically approved for use on the NHS. In winter 2022 the Department of Health and Social Care (DHSC) handed the appraisal process over to NICE, who have since finished their review of Evusheld. NICE’s role was to decide whether the treatment is a cost effective use of NHS resources, comparing the benefits with the cost of delivering the treatment.

NICE have decided Evusheld will not be approved for use on the NHS in England, Scotland, Wales or Northern Ireland. You can read more about this decision in our article here.

Can I get Evusheld privately? 

From the 19th October 2022 onwards, AstraZeneca, the company which manufactures Evusheld, informed people that the treatment would be available to patients privately across the UK. This means you can request a prescription from a private doctor and they can prescribe it.

Will I be eligible for Evusheld? 

According to the MHRA licence, Evusheld is suitable for adults who are not currently infected with COVID-19 and who have not had a known recent exposure to an individual infected with COVID-19 and:

  • Who are unlikely to mount an adequate immune response to COVID-19 vaccination or
  • For whom COVID-19 vaccination is not recommended.

As Evusheld is now available privately, it will be down to individual doctors to decide whether a patient fits the MHRA licence criteria and whether to prescribe Evusheld. 

Is Evusheld still effective now? 

The main trial of Evusheld started back in 2020 when the COVID-19 variants in circulation were different from those in circulation now. The results from this trial are therefore no longer applicable and it is unlikely that Evusheld is as effective as it was against most of the current variants. To read more about this, including how this impacted NICE’s decision not to approve Evusheld on the NHS, please see our other article on Evusheld here.

How much does Evusheld cost and how many doses do I need? 

We have been informed that Evusheld will cost approximately £1,200 per dose. However, there will be additional costs on top of this, including the cost of the consultation and administration.  As an estimate, additional costs could amount to a total cost to the patient of around £1,750 per dose. This may vary between healthcare providers.

As Evusheld is a combination of the drugs tixagevimab and cilgavimab, one dose of Evusheld (600mg) is given as two separate injections – 300mg of tixagevimab and 300mg of cilgavimab.

According to clinical trials, Evusheld’s effectiveness reduces significantly at around 6 months post jab. As a result, AstraZeneca advises patients to have a repeat dose 6 months after their first one, which we expect would cost the same amount as the first dose.

How and where can I get Evusheld privately? 

As a first step, we would recommend enquiring with your secondary care team, such as a doctor (consultant haematologist) if you have one. You can discuss with them whether Evusheld could be beneficial for you or not. This doctor could also write a private prescription for Evusheld for you. Alternatively, you could enquire directly with a private hospital, the details of which you can find online. Some private healthcare insurers are also providing Evusheld, so if you have this type of insurance you could contact the company to enquire. 

What should I do to protect myself if I can’t access Evusheld?

You should continue to receive all appropriate COVID-19 vaccinations when you are invited for them. In the event that you test positive for COVID-19 you will be assessed for receiving antiviral treatments, providing you are eligible. These antiviral treatments can help some immunocompromised people manage their COVID-19 symptoms and reduce the risk of them becoming seriously ill.

What are Leukaemia Care doing to help make Evusheld available on the NHS? 

Since Evusheld was licensed, we worked to influence the process to get it approved where possible for vulnerable leukaemia patients. To start this included conversations with DHSC, parliamentary questions and a joint letter with other charities to try to obtain transparency on the Government’s decision-making process. 

Leukaemia Care were then invited to be a consultee on the NICE appraisal of Evusheld, and have submitted a patient organisation response reflecting leukaemia patients’ experiences and views on Evusheld. In the submission we used quotes and patient stories to illustrate the value to patients of having Evusheld approved on the NHS.

We are disappointed with NICE’s decision not to approve Evusheld on the NHS. You can read more about our position on this here. We will continue to engage where possible to advocate for access on behalf of leukaemia patients. 

If you have any questions about this announcement, please contact advocacy@leukaemiacare.org.uk.

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