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Tixagevimab plus cilgavimab for preventing COVID‑19

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1 Recommendations

1.1 Tixagevimab plus cilgavimab is not recommended, within its marketing authorisation, for preventing COVID‑19 in adults who are not currently infected with SARS‑CoV‑2 and who have not had a known recent exposure to someone infected with SARS‑CoV‑2, and:

  • who are unlikely to have an adequate immune response to COVID‑19 vaccination, or

  • for whom COVID‑19 vaccination is not recommended.

Why the committee made these recommendations

Although clinical studies of tixagevimab plus cilgavimab suggest a reduction in COVID‑19 infection compared with no preventative treatment, these studies were done early in the pandemic when different variants of the COVID‑19 virus were circulating. More recent studies done in laboratories report that tixagevimab plus cilgavimab is unlikely to prevent infection with most of the relevant variants in the appropriate time period for this evaluation (January 2023 and the 6 months after).

The limitations in the clinical evidence mean it is not possible to make a reliable cost-effectiveness estimate. Tixagevimab plus cilgavimab is unlikely to be an acceptable use of NHS resources, so it is not recommended. Further research is recommended to address some of the uncertainties in this rapidly changing disease area (see section 4).