Nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19

  • Technology appraisal guidance
  • TA878
  • Published: 
  • Last updated: 

Information for the public

The following are available on the NHS as possible treatments for COVID‑19:

  • nirmatrelvir plus ritonavir (Paxlovid) for adults who:
    • do not need oxygen therapy for COVID‑19 and
    • are more likely to develop severe COVID‑19
  • sotrovimab (Xevudy) for adults and young people 12 years and over who weigh at least 40 kg and who:
    • do not need oxygen therapy for COVID‑19 and
    • are more likely to develop severe COVID‑19 and
    • cannot have nirmatrelvir plus ritonavir.
  • tocilizumab (RoActemra) for adults who:
    • need oxygen therapy for COVID-19 and
    • are having systemic corticosteroids.

Information on nirmatrelvir plus ritonavir

From March 2024, the NHS will also make nirmatrelvir plus ritonavir available to adults who do not need oxygen therapy for COVID‑19 and who:

  • are aged 85 years and over
  • have end-stage heart failure and have a long-term ventricular assistance device (a mechanical device that helps the heart pump blood)
  • are on the organ transplant waiting list
  • are aged 70 years and over, or who have a body mass index (BMI) of 35 kg/m2 or more, diabetes or heart failure, and who are:
    • resident in a care home or
    • already in hospital.

By June 2025, nirmatrelvir plus ritonavir will be available on the NHS for adults who do not need oxygen therapy for COVID-19 and who:

  • are aged 70 years and over
  • have a BMI of 35 kg/m2 or more
  • have diabetes
  • have heart failure.

People more likely to develop severe COVID‑19

Some people have a health condition that may increase their risk of getting seriously ill from COVID‑19, such as:

  • Down’s syndrome
  • certain types of cancer, including leukaemia
  • certain conditions affecting the blood, such as sickle cell disease
  • people who have had a stem cell transplant
  • kidney disease
  • liver disease
  • people who have had an organ transplant
  • conditions affecting the immune system, such as HIV or AIDS, inflammatory conditions or immunodeficiency
  • conditions affecting the brain or nerves (multiple sclerosis, motor neurone disease, Huntington’s disease or myasthenia gravis).

The full list of conditions is available in the independent advisory group report commissioned by the Department of Health and Social Care.

Is treatment right for me?

Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns. Your family can be involved too, if you wish. See our webpage on making decisions about your care.

Questions to think about

  • How well does it work compared with other treatments?
  • What are the risks or side effects? How likely are they?
  • How will the treatment affect my day-to-day life?
  • What happens if the treatment does not work?
  • What happens if I do not want to have treatment? Are there other treatments available?

Information and support

The NHS webpage on COVID-19 may be a good place to find out more.

These organisations can give you advice and support:

You can also get support from your local Healthwatch.

NICE is not responsible for the quality or accuracy of any information or advice provided by these organisations.

ISBN: 978-1-4731-5817-7

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