How are you taking part in this consultation?

You will not be able to change how you comment later.

You must be signed in to answer questions

  • Question on Consultation

    Has all of the relevant evidence been taken into account?
  • Question on Consultation

    Are the summaries of clinical and and cost effectiveness reasonable interpretations of the evidence?
  • Question on Consultation

    Are the recommendations sound and a suitable basis for guidance to the NHS?
  • Question on Consultation

    Are there any aspects of the recommendations that need particular consideration to ensure we avoid unlawful discrimination against any group of people on the grounds of race, sex, disability, religion or belief, sexual orientation, age, gender reassignment, pregnancy and maternity?
The content on this page is not current guidance and is only for the purposes of the consultation process.

1 Recommendations

1.1 Nirmatrelvir plus ritonavir is recommended as an option for treating COVID-19 in adults, only if they:

Why the committee made this recommendation

This evaluation reviews the clinical and cost effectiveness of nirmatrelvir plus ritonavir for mild COVID-19. Most of the clinical evidence for this treatment is highly uncertain because it comes from studies done before the dominant Omicron variants of SARS-CoV-2 (the virus that causes COVID‑19).

The cost-effectiveness estimates are highly dependent on how well the treatment works compared with standard care, and hospitalisation and mortality rates. Hospitalisation and mortality rates are lower with Omicron variants than earlier variants in the pandemic. They also get lower as the risk of severe COVID-19 decreases. These lower rates increase the cost-effectiveness estimates.

Clinical evidence suggests that nirmatrelvir plus ritonavir is effective at treating mild COVID-19 compared with standard care.

The independent advisory group report commissioned by the Department of Health and Social Care defines people with the highest risk of progression to severe COVID-19. Nirmatrelvir plus ritonavir is recommended for treating COVID-19 in these groups because the likely cost-effectiveness estimates are within what NICE considers an acceptable use of NHS resources.

The Therapeutics Clinical Review Panel modelling group findings on risk of severe COVID-19 outcomes identifies additional groups of people with an increased risk of severe COVID-19. But, the likely cost-effectiveness estimates for nirmatrelvir plus ritonavir in these groups are above what NICE considers an acceptable use of NHS resources.