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New setback for the Covid-vulnerable as NHS watchdog axes four more lifeline drugs

Four Covid drugs which kept thousands of vulnerable Britons out of hospital were quietly withdrawn last week after the NHS spending watchdog withdrew funds from them

Four Covid drugs which kept thousands of vulnerable Britons out of hospital were quietly withdrawn last week after the NHS spending watchdog withdrew funding from them.

While Covid vaccines and boosters provide strong protection against serious illnesses for most of the population, around 500,000 people suffer from conditions that mean their bodies do not react to bites, putting them at serious risk of contract the virus.

Since last year, these patients – who mainly have blood cancers like leukemia, kidney disease or who have undergone an organ transplant – have been able to access five anti-Covid drugs that prevent them from becoming seriously ill and to end up in the hospital. But on Wednesday, the National Institute for Health and Care Excellence (NICE) said it would withdraw four of them from NHS use because they are no longer considered cost-effective.

Worryingly, this will leave thousands of people with kidney disease with no treatment available to prevent them from being hospitalized with Covid. The only remaining drug, Paxlovid, cannot be used by these patients due to its severe side effects.

Four Covid drugs which kept thousands of vulnerable Britons out of hospital were quietly withdrawn last week after the NHS spending watchdog withdrew funds from them

Four Covid drugs which kept thousands of vulnerable Britons out of hospital were quietly withdrawn last week after the NHS spending watchdog withdrew funds from them

“It’s disappointing, surprising and unfair,” says Fiona Loud, policy director at the charity Kidney Care UK. “These treatments have been an important safety net for people with kidney disease, who remain among the most vulnerable to Covid and least protected from vaccines.”

The news also renewed calls for the government to fund the drug Evusheld, a six-monthly injection created by AstraZeneca, the British company behind one of the first Covid vaccines, which has been shown to prevent vulnerable patients from catching the virus in the first place. However, as this newspaper reports, although Evusheld was approved by UK health regulators in March, ministers say it is still unclear whether the drug is effective against the latest variant of Omicron. The drug is already in use in 32 other countries, including the United States, France and Israel. Currently, Evusheld is only available privately in the UK, costing over £1,000 a dose.

“The delay in providing Evusheld, coupled with this proposal to cut many treatment drugs, leaves kidney patients vulnerable with no prospect of protection or treatment unless they are willing to pay thousands of pounds in their own pockets,” says Mark Oakley of the UK campaign group Evusheld. “It is completely unfair and contrary to the government’s promise to protect the most vulnerable.”

As many as 500,000 Britons are thought to have failed to respond to Covid vaccines. Either they have conditions that leave the immune system weakened, or they take treatments that suppress the immune system, severely limiting the protection provided by the bites.

Evusheld is a combination of two drugs – tixagevimab and cilgavimab – which works by binding to the Covid virus and inhibiting its ability to bind to healthy cells and infect the body. Given as an injection every six months, studies show it can reduce the risk of infection by 50% and the likelihood of death from Covid by more than 80%.

As many as 500,000 Britons are thought to have failed to respond to Covid vaccines.  Either they have conditions that leave the immune system weakened, or they take treatments that suppress the immune system, severely limiting the protection provided by the bites.

As many as 500,000 Britons are thought to have failed to respond to Covid vaccines. Either they have conditions that leave the immune system weakened, or they take treatments that suppress the immune system, severely limiting the protection provided by the bites.

The Department of Health and Social Care has repeatedly stated that the availability of other anti-Covid drugs negates the need to purchase Evusheld. NICE recommended continued funding for Paxlovid, but said it was “highly uncertain” that the other four drugs available – sotrovimab, molnupiravir, remdesivir and ronapreve – would work against the latest Covid variants. Therefore, from January they will no longer be offered.

“If the only drug left is Paxlovid, patients with kidney failure will really suffer,” says Dr Lennard Lee, an oncologist at Oxford University.

“I understand that NICE wants to make sure treatments are cost-effective for the NHS, but they need to think about how much protection that leaves for the vulnerable this winter.”

The government has reason to be cautious about funding Covid drugs. Research last month found that the widely prescribed drug molnupiravir did not reduce Covid hospitalizations in the UK, despite around £1bn being spent on over 2, 2 million doses.

Paxlovid has already cost the taxpayer more than £1.2 billion for 2.7 million doses. NICE says a final decision will be made in January.

One patient who fully understands the danger Covid still poses is Jo Barrett, 51, from Manchester, who was hospitalized with the virus in October 2021.

Jo, a special education teacher, underwent two kidney transplants due to a genetic disease. She caught Covid from a student despite three shots. She was admitted to hospital for treatment, but her condition continued to deteriorate. Eventually, she had to be placed in a medically induced coma and put on a ventilator for five weeks.

“It was a terrifying experience and I’m still recovering a year later,” says Jo.

Jo wants to go back to work but her school has put her on indefinite leave until they can guarantee she won’t fall seriously ill with Covid again.

“They think it’s too risky to have me in school,” Jo says. “So without Evusheld and the antiviral drugs, I can’t go back. I’m going to lose my job because the government won’t fund these drugs – it’s terrible.

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