Overview: access to COVID-19 treatments in the UK

Published: 21st February 2023

Following the interim decision by the National Institute of Health and Care Excellence (NICE) on Evusheld last week, today NICE has announced its final decision on a separate review of other COVID-19 treatments. In this article, we explain how the two decisions are different and what they mean for you.

What COVID-19 treatments have NICE been reviewing?

The National Institute of Health and Care Excellence (NICE) is the body that makes decisions on which treatments should be used by the NHS. NICE have recently been reviewing two types of COVID-19 treatments separately: 

1. Whether the NHS should use the antibody Evusheld as a treatment for COVID-19 that is given before you are exposed to the virus (prophylaxis). The idea of this treatment would be to help protect people thought not to be protected by vaccines. 
2. treatments for COVID-19 that are given after you are exposed to the virus to speed up recovery. This appraisal looked at both antibody treatments (including Evusheld) and antiviral drugs.

Currently, Evusheld has a license for private use in the UK, and is not available to patients via the NHS. NICE have therefore been reviewing whether to make it available to patients on the NHS. 

By contrast, the range of post-exposure treatments being reviewed are already available on the NHS if patients contract COVID-19. This is thanks to a decision made by the Departments of Health across the UK in late 2021. Therefore NICE has been reviewing whether these are still cost effective use of NHS resources. to withdraw any existing NHS access to these treatments. 

These decisions are independent of one another. Each decision is therefore at a different stage of the process. Please read on later in this article to understand what each decision means for you or for leukemia patients you know. 

Whilst all these announcements have been made by NICE, the body that makes decisions for England, we understand that these decisions will then apply to other UK nations too.

What does today’s decision on Evusheld mean for me?

Today NICE made an initial interim decision not to approve Evusheld on the NHS. NICE have made this initial decision largely because the data on whether Evusheld works against the current COVID-19 variants is uncertain. 

However, the decision not to approve Evusheld on the NHS is not a final decision yet, and could be subject to change. Leukaemia Care and other participants will now have the chance to comment on the draft guidance for consideration by NICE before they make a final decision. Leukaemia Care will continue to engage throughout the rest of the NICE appraisal, pushing for access to Evusheld for those who want it. 

Leukaemia Care’s CEO Zack Pemberton-Whitely commented on the process saying “As variants of COVID-19 are constantly changing, we feel that the standard NICE process is not fit for purpose for the future review of COVID-19 treatments.”

To read more about this decision from NICE and our position on it, you can read the full article on our website here. To understand more about what Evusheld is and how to access it privately you can read our blog on that here. 

What does today’s decision on post-exposure treatments mean for me?

Another decision published by NICE today is the decision to withdraw access to a significant amount of the COVID-19 treatments currently on offer on the NHS. 

Previously a range of post-exposure antiviral and monoclonal antibody treatments were available in both community and hospital settings to eligible patients should they test positive for COVID-19. However, according to NICE’s recent decision, the antiviral treatment paxlovid (nirmatrelvir/ritonavir) and the monoclonal antibody sotrovimab will be the only treatments which will continue to be available to patients outside of hospital whilst they are experiencing mild illness (reducing current offerings in this setting by half). 

We at Leukaemia Care are concerned about this decision to reduce access to a range of options which can meet different patient needs. Paxlovid is a drug which cannot be taken alongside many leukaemia treatments, giving some patients only one treatment option left (sotrovimab). We are disappointed that the NICE committee decided not to approve more treatments which are less likely to interact with leukaemia treatments.

Leukaemia Care’s CEO, Zack Pemberton-Whitely commented “We are disappointed with the decision by NICE to remove access to the majority of COVID-19 treatments currently available to patients on the NHS. Many of these patients remain at higher risk of COVID-19, as they may have responded less well to vaccination. NICE’s decision today removes a vital safety-net. This is a significant step back and puts leukaemia patients, for whom the pandemic is far from over, at an even greater risk of serious illness.”

To read more about which other treatments will no longer be in use on the NHS, including those used in hospitals, please read the full blog here.