NICE confirms ‘no’ decision for COVID-19 drug Evusheld

Monday 15 May 2023

NICE (National Institute for Health and Care Excellence) has decided not to recommend Evusheld for use on the NHS in England. This confirms their February draft guidance which said the same thing.

This decision means Evusheld won’t be available on the NHS in England. This is likely to apply to the rest of the UK too.

Why have NICE reviewed Evusheld?

NICE have reviewed Evusheld to decide if it should be offered on the NHS. Evusheld is a drug to prevent COVID-19 symptoms. Since March 2022 it’s been licensed for adults who are unlikely to develop a good immune response from COVID vaccines. That includes some people with MS, such as those who take certain disease modifying therapies (DMTs).

At the moment, Evusheld is only available privately in the UK. NICE have looked at the available evidence on Evusheld to decide if it should be available on the NHS.

Why has Evusheld been rejected?

NICE have not recommended Evusheld because recent studies suggest it’s unlikely to prevent COVID-19 infection with newer variants like Omicron.

Earlier results from Evusheld studies were positive, but these were based on infections with older COVID-19 variants. And those older variants have become less common. 

NICE say it’s impossible to say how cost-effective Evusheld would be on the NHS.

Does this NICE decision on Evusheld apply to the whole of the UK?

NICE’s Evusheld decision will likely apply to the NHS across the UK, but each nation will have its own process for deciding this.

For this review of Evusheld, NICE and the Scottish Medicines Consortium (SMC) agreed to collaborate and agree on the recommendations. NICE guidance is implemented in Wales and there is an established processes for endorsing NICE guidance for implementation in Northern Ireland.

What else is in the NICE guidance?

This NICE guidance highlights the urgent need for more research – to find effective treatments that can prevent COVID-19 for people at high risk.

NICE say COVID-19 research needs to include:

  • more clinical trial evidence, with Evusheld evaluated more quickly when there are new COVID-19 variants
  • more research into the impact of preventative treatments like Evusheld for people at high risk

NICE are also exploring ways they can respond better to rapidly emerging evidence on COVID-19 treatments. They also want to make sure guidance can be reviewed and updated as quickly as possible.

NICE’s decision on Evusheld is based on the best available evidence, so we don’t plan to challenge their decision not to recommend it on the NHS. We agree that much more can be done to find effective alternative treatments and will be engaging with NICE on how to support this work.

Does the NICE decision affect private Evusheld prescriptions?

NICE only decides on access to treatments on the NHS, so Evusheld is still available privately. If you do access Evusheld privately, you can still do this if you feel it's right for you. Speak to your neurologist if you're unsure about any part of your treatment.

Read more about COVID-19 and MS