Changes to prescribing antiviral and antibody treatments for COVID-19 (WHC/2025/010)
New NICE advice for accessing treatments in adults at risk from severe COVID-19.
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Details
Status:
Action.
Category:
Public health.
Title:
Arrangements for the prescribing of antiviral and neutralising monoclonal antibody treatments for COVID-19.
Date of expiry / review:
Not applicable.
Action by:
- General practitioners.
- Community pharmacies.
- Chief executives, health boards/trusts.
- Medical directors, health boards/trusts.
- Directors of primary care, health boards/trusts.
- Nurse executive directors, health boards/trusts.
- Executive directors therapies and health science.
- Directors of public health, health boards/trusts.
- Directors of pharmacy/chief pharmacists, health boards/trusts.
- General Practitioner Committee, Wales.
- Community Pharmacy Wales.
Required by:
Non-applicable.
Sender:
Chief Pharmaceutical Officer,
Health, Social Services, and Early Years Group,
Welsh Government.
Welsh Government contacts:
Pharmacy and Prescribing Branch,
Welsh Government,
Cathays Park,
Cardiff.
CF10 3NQ.
Email: Pharmacyand.PrescribingBranch@gov.wales
Enclosures
Annex: changes to prescribing antiviral and antibody treatments for COVID-19.
Letter
Dear Colleague,
The National Institute for Health and Care Excellence (NICE) recommends the use of the antiviral medicine nirmatrelvir and ritonavir (Paxlovid®) and the neutralising monoclonal antibody treatment sotrovimab as options for treating COVID-19 in adults if they at an increased risk for progression to severe COVID-19, as defined in Technology appraisal guidance TA878 Nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19.
For patients in this cohort whom both nirmatrelvir and ritonavir, and sotrovimab are contraindicated or unsuitable, draft NICE guidance recommends the use of the antiviral medicine molnupiravir (Lagevrio®) for the treatment of mild to moderate COVID-19.
Since November 2021, COVID-19 antiviral treatment for this clinically extremely vulnerable group has been available through treatment pathways operated by local health boards with antiviral medicines available only through centrally procured stock.
We have been working with manufacturers and the UK Government’s Department for Health and Social Care to finalise arrangements for long term sustainable supply of both nirmatrelvir and ritonavir and molnupiravir and anticipate both will be available for community pharmacies and dispensing doctors, as well as hospitals, to order through business as usual supply chains, in the coming months.
In preparation for routine availability of antiviral medicines we have agreed changes to the treatment pathway for those who are eligible for treatment with COVID-19 antiviral medicines, with the General Practitioner Committee, Wales. The changes mean from later this spring, anyone in an eligible group (see annex) will be able to contact their GP practice, or out-of-hours service, if they test positive for COVID-19 to be clinically assessed for prescription of anti-viral medication. Prescriptions will be able to be dispensed by community pharmacies and dispensing doctors.
Further information including treatment guidelines and confirmation of the date from which supplies will be available to order from wholesalers will be made available shortly. In the meantime, health boards are required to work with primary care contractors in their area to put in place local treatment pathways which provide continued access to antiviral treatment and systems to enable the referral of eligible patients for whom nirmatrelvir and ritonavir is contraindicated or unsuitable, for intravenous administration of sotrovimab.
Prescribers are reminded that treatment for COVID-19 in the community should be offered only where SARS-COV-2 infection has been confirmed by lateral flow device (LFD) or polymerase chain reaction (PCR) test and where treatment can be commenced within five days of symptom onset. Antiviral medicines are not licensed or effective for the prophylaxis of COVID-19.
Free LFD test kits are available for people eligible for COVID-19 antiviral treatment and can be collected from the majority of community pharmacies in Wales. Details of community pharmacies providing free LFD test kits can be found by visiting the NHS 111 Wale website and searching services near you.
Clinicians and pharmacists are asked to remind existing and newly eligible people of the availability of free LFD test kits and how to access them.
Yours sincerely,
Andrew Evans,
Chief Pharmaceutical Officer,
Welsh Government.