NICE consultation on Covid-19 treatments

NICE (National Institute for Health and Care Excellence) is currently reviewing the drug treatments used to treat Covid-19. They have issued draft guidance for consultation which recommends that only three out of the eight treatments they have reviewed are available on the NHS. This is draft guidance and therefore it will not affect which drug treatments people are currently offered should they test positive for Covid-19. NICE will review all the comments received during this consultation and issue final guidance early in 2023. Kidney Care UK will be commenting.

Fiona Loud, Policy Director for Kidney Care UK, said, "We are extremely concerned about this draft guidance because if it is finalised, it would leave people with kidney disease with no available therapeutic treatments for Covid-19 unless they become ill enough to need hospital admission. We think that it is disappointing, surprising and unfair. NICE’s draft guidance recommends only one of the four community treatments (Paxlovid) and that drug is not suitable for people with late kidney disease, for example those with transplants or on dialysis. These individuals would therefore be left with no community treatment options should they get Covid-19, despite being one of the groups who remain at highest risk of severe illness and death and who have the least protection from their vaccines.

"The Covid-19 therapeutic treatments, particularly Sotrovimab, have been a very important safety net for people with kidney disease. Kidney Care UK strongly supports the UK Kidney Association call for its ongoing availability, particularly given the lack of other options. Furthermore there is presently no access to prophylactic treatments such as Evusheld. We urge NICE to consider all the evidence against a backdrop of ongoing risk and no current alternatives."

Kidney Care UK will be working together with clinical colleagues to respond to NICE’s consultation, to make sure the views of people living with kidney disease are heard when deciding the final guidance.

The draft guidance is available on NICE’s website and individuals can submit comments by registering with NICE.

Please contact us on [email protected] if you would like us to take your views into our response back to NICE.

The eight treatments NICE looked at are:

• nirmatrelvir/ritonavir
• tocilizumab
• remdesivir
• molnupiravir
• sotrovimab
• casirivimab/imdevimab
• baricitinib
• tixagevimab/cilgavimab

The three they are recommending in the draft guidance are:

• nirmatrelvir/ritonavir (Paxlovid), for treating Covid-19 in adults at high risk of progressing to severe Covid-19
• tocilizumab for treating severe Covid-19 (if the company provides it according to a commercial arrangement)
• baricitinib for treating severe Covid-19 (subject to the drug receiving marketing authorisation in Great Britain)