Evusheld and CKD: your questions answered

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?

Earlier studies of Evusheld found that it could 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 not be effective against the variants currently circulating in the UK.

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.

The Government announced on 12 August 2022 that it will not procure the treatment and make it available on the NHS at this time.

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) are doing 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. In February 2023,NICE published their draft recommendation not to make the drug available in the NHS because of limited evidence that is effective against current variants. Final guidance is expected in Spring.

We understand that the decision not to make Evusheld available in 2022 was incredibly disappointing for people who remain at higher risk from Covid-19. we continue to campaign for the Government to prioritise the development of new treatments that can offer protection against the virus and act quickly to make effective treatments available. We highlighted to NICE that prolonged decision making about drug treatments is not appropriate in the context of a virus like Covid. Subsequently, NICE announced they are developing a new process which will mean there is a continuous review of evidence and data about Covid-19 and its treatments, which should mean effective treatments can be made available more quickly.

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.

The Government’s planned antibody testing study will aim to inform decisions about any future pre-exposure treatment, based on an individual’s risk. The details are currently being finalised and we will update once we have more information,

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 have also added the monoclonal antibody sotrivomab and another drug, ciclesonide, to the clinical trial.

The manufacturers of Evusheld are also testing out a newer version of the drug treatment.

In his letter on December 2022 to patient groups, Will Quince MP said the Government “would like to reassure you and your members that we continue to closely monitor the market for new prophylactic options.”

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. The cost to patients will be over £1,200. It's not possible to say exactly how much, as it will depend on how much the provider decides to charge. We do not know of any kidney doctors who may be able to assist with a private purchase.

We would encourage people to consider new evidence suggesting Evusheld is unlikely to be as effective against newer variants when making a decision whether to purchase the drug.

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 has been available is via patients paying for it. We will continue to campaign for effective protective treatments to be made available to all who need them, via the NHS.