7 Update information
May 2025
The recommendation for nirmatrelvir plus ritonavir was updated. The recommendation made in March 2024 after a partial review of the guidance was based on a confidential price offered by the company to the NHS. In May 2025, the company set a new list price of £829. This was because NICE was considering if the recommendation needed to be reviewed due to the evolving COVID-19 landscape and emerging data from NHS England. Nirmatrelvir plus ritonavir is no longer cost effective for the groups evaluated in the partial review (people with diabetes, obesity or heart failure, or aged 70 years or over). So, these groups were removed from the recommendation.
Nirmatrelvir plus ritonavir remains cost effective for the highest-risk group, so this recommendation remains in place.
We also:
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updated the list price in section 2.7
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updated sections 3.42 and 3.46 to reflect the updated recommendation
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removed sections 4.5 to 4.15 because the funding variation for nirmatrelvir plus ritonavir related to the recommendation that has been withdrawn.
June 2024
The wording of the recommendation describing the commercial arrangement (see section 1.3), and in section 2.9, has been updated to include procurement information about tocilizumab biosimilars.
March 2024
After a partial review of this guidance, we updated the recommendation on nirmatrelvir plus ritonavir to include additional groups eligible for treatment (people with diabetes, obesity or heart failure, or aged 70 years or over).
We removed the recommendation on casirivimab plus imdevimab because the conditional marketing authorisation for casirivimab plus imdevimab for treating COVID‑19 was withdrawn.
June 2023
We added a section with supporting information on risk factors for progression to severe COVID‑19. This supporting information was provided by the independent advisory group commissioned by the Department of Health and Social Care.
April 2023
We updated the recommendations on nirmatrelvir plus ritonavir and sotrovimab to link to the updated independent advisory group report commissioned by the Department of Health and Social Care.
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