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Therapeutics for people with COVID-19

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2 Information about the treatments

Marketing authorisation indications and anticipated marketing authorisation indications

2.1 Casirivimab plus imdevimab (Ronapreve, Roche Products) is 'indicated for the prophylaxis and treatment of acute Covid-19 infection'.

2.2 Molnupiravir (Lagevrio, Merck Sharp & Dohme) is 'indicated for treatment of mild to moderate coronavirus disease 2019 (COVID-19) in adults with a positive SARS-COV-2 diagnostic test and who have at least one risk factor for developing severe illness'.

2.3 Nirmatrelvir plus ritonavir (Paxlovid, Pfizer) is 'indicated for the treatment of COVID-19 in adults who do not require supplemental oxygen and who are at increased risk for progression to severe COVID-19'.

2.4 Remdesivir (Veklury, Gilead Sciences) is 'indicated for the treatment of coronavirus disease 2019 (COVID-19) in:

  • adults and paediatric patients (at least 4 weeks of age and weighing at least 3 kg) with pneumonia requiring supplemental oxygen (low- or high-flow oxygen or other non-invasive ventilation at start of treatment)'.

  • adults and paediatric patients (weighing at least 40 kg) who do not require supplemental oxygen and who are at increased risk of progressing to severe COVID-19'.

2.5 Sotrovimab (Xevudy, GlaxoSmithKline) is indicated 'for the treatment of symptomatic adults and adolescents (aged 12 years and over and weighing at least 40 kg) with acute covid-19 infection who do not require oxygen supplementation and who are at increased risk of progressing to severe covid infection'.

2.6 Tocilizumab (RoActemra) is indicated 'for the treatment of coronavirus disease 2019 (COVID-19) in adults who are receiving systemic corticosteroids and require supplemental oxygen or mechanical ventilation'.

2.7 Tixagevimab and cilgavimab (Evusheld, AstraZeneca) is indicated 'for the treatment of COVID-19 in adults who do not require supplemental oxygen and who are at increased risk of progressing to severe COVID-19'.

2.8 Baricitinib (Olumiant, Eli Lilly and Company) does not have a marketing authorisation in Great Britain yet for treating COVID-19.

Dosage in the marketing authorisation

2.9 The dosage schedule for casirivimab and imdevimab is available in the summary of product characteristics for casirivimab plus imdevimab.

2.10 The dosage schedule for molnupiravir is available in the summary of product characteristics for molnupiravir.

2.11 The dosage schedule for nirmatrelvir and ritonavir is available in the summary of product characteristics for nirmatrelvir plus ritonavir.

2.12 The dosage schedule for remdesivir is available in the summary of product characteristics for remdesivir.

2.13 The dosage schedule for sotrovimab is available in the summary of product characteristics for sotrovimab.

2.14 The dosage schedule for tocilizumab is available in the summary of product characteristics for tocilizumab.

2.15 The dosage schedule for tixagevimab plus cilgavimab is available in the summary of product characteristics for tixagevimab plus cilgavimab.

2.16 The dosage schedule for baricitinib will be available in the summary of product characteristics for baricitinib.

Price

2.17 The list price for casirivimab plus imdevimab is currently confidential.

2.18 The list price for molnupiravir is currently confidential.

2.19 The list price for nirmatrelvir plus ritonavir is £829 for a 20‑pack of 150‑mg nirmatrelvir tablets and a 10‑pack of 100‑mg ritonavir tablets (excluding VAT; MIMS online, accessed October 2022). Costs may vary in different settings because of negotiated procurement discounts.

2.20 The list price for remdesivir is £340 per 100 mg vial (excluding VAT; BNF online, accessed October 2022). Costs may vary in different settings because of negotiated procurement discounts.

2.21 The list price for sotrovimab is £2,209 for 500 mg/8 ml concentrate for solution for infusion vial (excluding VAT; BNF online, accessed October 2022). Costs may vary in different settings because of negotiated procurement discounts.

2.22 The list price for tixagevimab and cilgavimab is currently confidential.

2.23 The list price for tocilizumab is £256 per 200 mg/10 ml and £512 per 400 mg/20 ml concentrate for solution for infusion vial (excluding VAT; BNF online, accessed October 2022). The company has a commercial arrangement (simple discount patient access scheme). This makes tocilizumab available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.

2.24 The list price for baricitinib is £805.56 for a 28‑pack of 4 mg tablets (excluding VAT; BNF online, accessed October 2022). The company has a commercial arrangement (simple discount patient access scheme). This makes baricitinib available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.