Hi all, hope you’re all doing okay - we know the uncertainty around this is really hard.
NICE have published their draft guidance on which post-exposure Covid treatments to recommend or not recommend for use. NICE’s guidance must be followed by the NHS.
In their draft guidance, NICE have concluded that the following treatments are not cost effective:
- casirivimab plus imdevimab
- molnupiravir
- remdesivir
- sotrovimab
- Evusheld (used as post-exposure)
However, NICE have decided that, in the community setting, Paxlovid should remain in use, and tocilizumab should remain in use for hospitalised patients on supplemental oxygen. There is no treatment recommended for use for hospitalised patients not on supplemental oxygen. But for those patients who are hospitalised with Covid and aren’t yet on oxygen, there are non-Covid-specific treatments that are given, like corticosteroids.
NICE’s decisions around this have been based on a cost-effectiveness analysis which took into account: 1) hospitalisation rates, (2) time to discharge from hospital, (3) Long Covid costs, (4) administrative costs, and (5) hospitalisation costs.
It’s important to note that this is draft guidance and does not change policy until final guidance is issued in the spring. NICE will meet at the end of January to consider any rebuttals (including from patient support organisations). They will then produce and disseminate final guidance in or around March.
Patients will still be offered the current treatments until supplies run out. It is therefore likely that patients will continue to have access to all treatments over the winter period.
We totally understand that the uncertainty around this will be difficult for many people in the blood cancer community. Please be assured, that we are working hard to amplify the issues and concerns of the blood cancer community to the decision makers within the government. Blood Cancer UK are official stakeholders in the NICE appraisal, so we have the opportunity to comment on NICE’s draft guidance and decision. In our initial submission, we explained the Paxlovid has a lot of drug interactions with some treatments commonly given to people as part of their blood cancer care. We also explained that their decision should take into account the range of benefits provided by Covid treatments that aren’t captured solely by clinical efficacy data (like hospitalisation rate, for example).
We will continue to argue that there should be an alternative treatment available for people who cannot take Paxlovid due to drug interactions. It’s important to us that NICE understands that it can be harmful for people with blood cancer to stop taking treatments they need for their cancer care. NICE appreciates our input because the patient experience is important to them, so we hope that they’ll carefully consider our comments. There are dozens of other patient support organisations who will also be commenting on their draft guidance, including Anthony Nolan, Leukaemia Care, Leukaemia UK, Chronic lymphocytic leukaemia (CLL) Support, and Lymphoma Action. We all worked together on our original submission to NICE and will be sending separate comments to NICE to maximise our impact and ensure they understand that this is an issue that’s important to our community.
You may find it useful to read through our webpage here, which we are continually reviewing and updating: Antibody and antiviral treatments for people with blood cancer.
If you’re worried by this news, you may find it useful to talk to your haematology team/GP about a plan for if this guidance is approved in the spring, to make sure you’re aware which treatments you’re eligible for in the event of testing positive for Covid.
Please be assured that we will continue to update the blood cancer community as we learn more.
If any of you want to talk any of this through, we’re only a phone call or an email away, so please don’t hesitate to get in touch.
Take care all and remember we’re here if there’s anything we can do to support you.