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NICE recommends huge expansion of Covid-19 antiviral eligibility in at-risk groups

Around 1.4 million more people in the UK will be eligible for antiviral treatment nirmatrelvir plus ritonavir (brand name Paxlovid) if they test positive for Covid-19 after final draft guidance from the National Institute for Health and Care Excellence widens access.

It follows a partial review of the evidence that identified additional groups of people who are at increased risk of severe Covid-19.

Under the recommendations, nirmatrelvir plus ritonavir will be available after a positive Covid-19 test to people aged 85 and over, as well as people who are resident in a care home or are already hospitalised and are aged 70 years and over, have a body mass index greater than 35 kg/m2 or have diabetes or heart failure.

People with end-stage heart failure who have a long-term ventricular assistance device and those on the organ transplant waiting list will also be eligible.

The eligibility is in addition to the 3.9 million people who were already identified as being as increased risk of progression to severe illness if they were infected with Covid-19, NICE said.

Those who are eligible can get free lateral flow tests from participating pharmacies and should take a test as soon as they have symptoms, even if mild, NICE reiterated before calling their GP, NHS 111 or hospital specialist if they test positive.

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Helen Knight, director of medicines evaluation said: ‘Our review of the evidence on the use of Paxlovid has found it offers value for money for a wider group of patients.

‘This is good news for people who may contract Covid-19 in the coming months and will help alleviate pressure on the health service.‘

She added: ‘Although we are no longer in a pandemic, Covid-19 is still circulating and we are pleased that more people at risk of severe disease can benefit from Paxlovid.’

Nirmatrelvir plus ritonaviris is an antiviral medicine, given as two separate tablets to people within five days of Covid-19 symptom onset.

Nirmatrelvir stops the virus from growing and spreading, and ritonavir helps nirmatrelvir from being broken down in the body while it is working.

UK public health officials have reported rising levels of winter bugs in the past week with rates of flu, Covid-19 and norovirus continuing to rise.

The latest figures also show a rise in Covid-19 hospitalisations in the last week of 2023 as well as patients admitted to ICU with complications of the virus.