NICE gives thumbs-down to 5 COVID-19 drugs including AZ's Evusheld and Merck's Lagevrio

Five key products used to combat COVID-19 infection—including Merck’s antiviral Lagevrio—could be rejected for government funding in the U.K.

In draft guidance, the drug cost watchdog the National Institute for Health and Care Excellence (NICE) recommended against government coverage of the drugs because of concerns about either their cost or effectiveness. If the National Heath Service accepts the advice, there also would be no government coverage of Gilead’s Veklury, Regeneron’s Ronapreve, GSK-Vir Biotechnology’s Xevudy and AstraZeneca's Evusheld.

NICE is evaluating Evusheld as both a prophylactic and as a treatment for infected patients who are at risk for progressing to a severe form of the virus. This recommendation is for the latter. NICE advice on Evusheld's use as a preventative is due next year.

While cost is NICE’s issue with Lagevrio and Veklury, effectiveness is the primary concern with the other three—all antibody treatments. “It is highly uncertain whether (Ronapreve, Xevudy and Evusheld) are effective against the omicron variant,” NICE wrote.

Meanwhile, the regulator endorsed coverage of Pfizer’s oral antiviral Paxlovid, Roche’s Actemra and Eli Lilly’s Olumiant.

Paxlovid is used to reduce the risk of hospitalization and death in recently infected patients who are susceptible to progressing to a severe form of COVID. Actemra and Olumiant are rheumatoid arthritis drugs that were repurposed to combat severe infection in hospitalized patients who require supplemental oxygen.

Besides in the U.K., NICE's recommendation could also affect coverage decisions in other countries, particularly in Europe where regulators often take their cues from the U.K. Another factor influencing coverage decisions is the weakening effect of the virus as much of the world transitions from a pandemic to endemic phase.

Editor's Note: The story was edited to reflect that the NICE advice does not cover Evusheld's a prophylaxis.