What is Evusheld?
Evusheld is an antibody treatment developed for the pre-exposure prevention of Covid-19, sometimes referred to as pre-exposure prophylaxis. This means it is given to patients before they are exposed to the virus in order to prevent them from contracting Covid-19 if they are exposed to it. It is a combination of two long-lasting antibodies: tixagevimab and cilgavimab.
Antibodies are produced by the human body’s immune system following an infection like Covid-19 to help fight the virus. Antibody treatments are developed by selecting the antibodies best at killing the virus and working out how to manufacture them in the laboratory.
The Evusheld treatment was developed and produced by the pharmaceutical company AstraZeneca.
Antibody treatments are not a replacement for vaccination, which we continue to recommend for all kidney patients.
Does it prevent Covid?
Studies of Evusheld have found that it can reduce the risk of people developing or becoming seriously ill from Covid. However, these studies were done when a different variant was the most common variant circulating in the UK.
Recent data suggests that Evusheld may be less protective against some of the new variants. We are seeking advice on the level of protection that Evusheld might be able to offer.
Is Evusheld available in the UK?
The MHRA gave conditional approval for the use of Evusheld to prevent Covid in people whose immune response is poor in March 2022. However, MHRA approval does not mean the treatment was approved for use in the NHS.
A spokesperson for the Department of Health and Social Care said, "Following a robust review of the available data, our clinical experts advise there is currently insufficient data on the duration of protection offered by Evusheld in relation to the Omicron variant and the government will not be procuring any doses at this time.
“We are determined to support the most vulnerable as we live with Covid and immunocompromised patients are a priority for other treatments, access to free tests and vaccination."
The National Institute for Health and Care Excellence (NICE) have been asked to do a full evaluation of the clinical and cost effectiveness of the treatment. Kidney Care UK have shared the views and experiences of kidney patients with NICE. NICE’s final decision is not currently expected until Spring 2023.
We understand that this news is incredibly disappointing for people who remain at higher risk from Covid and we continue to campaign for the Government to reconsider and to prioritise the development of new treatments that can offer protection against the virus.
Which kidney patients might be able to access preventative treatments?
Medical colleagues have advised preventative treatments may be most beneficial for people who have not produced antibodies in response to vaccination, and this relatively small group could be identified through antibody testing by clinical teams. However, final decisions about which patient groups may be able to access any preventative treatments are made by NHS policy makers.
Are any other protective treatments in the pipeline?
A trial called PROTECT-V is evaluating the benefits of treatments that may prevent Covid, including a nasal spray called Niclosamide. They will also be adding the monoclonal antibody sotrivomab and another drug, ciclesonide, to the clinical trial.
Can I buy Evusheld?
On 19 October 2022, AstraZeneca, the pharmaceutical company that developed Evusheld, said that they have made Evusheld available to be purchased in the UK. We do not yet have the detail on how it can be accessed privately or the exact cost, which may be as much as £1,000 plus the cost of a private consultation with a doctor. We understand that a top-up dose would be needed every 6 months. Some people with private health insurance may be able to access the treatment via that route, depending on who their provider is. Evusheld can only be given by a healthcare professional and you will need a prescription to get it.
We would encourage people to consider new evidence suggesting Evusheld may not be as effective against newer variants when making a decision whether to purchase the drug. We will publish more information on this as soon as possible.
Questions from patients and clinicians should be addressed to the Medical Information and Patient Safety (MIPS) team at AstraZeneca ([email protected] or call 0800 783 0033).
Kidney Care UK believes it is a disgrace that the only way in which this drug can be made available right now is via people paying for it privately. We will continue to campaign for effective protective treatments to be made available to all who need them, via the NHS.
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