Research to access pathway for investigational drugs for COVID-19 (RAPID C-19)

RAPID C-19 is a multi-agency initiative. It aims to get treatments for COVID-19 to NHS patients quickly and safely.

It also helps frontline staff in health and social care understand the options they have for treating affected patients.

Who's involved

The initiative is a collaboration between:

  • NHS England and NHS Improvement
  • the Medicines and Healthcare products Regulatory Agency (MHRA)
  • the National Institute for Health Research (NIHR)
  • the National Institute for Health and Care Excellence (NICE)
  • Scottish Medicines Consortium (Healthcare Improvement Scotland)
  • All Wales Therapeutics and Toxicology Centre
  • All Wales Medicines Strategy Group
  • Northern Ireland Health and Social Care Board.

How it works

There are lots of clinical trials underway, working to find effective COVID-19 treatments.

RAPID C-19 works to speed up access to treatments where the research shows there is clinical benefit and they're proven to be safe and effective.

The process

  1. Primary horizon scanning and initial stratification

    The National Institute for Health Research (NIHR) Innovation Observatory scans all national and international trials for COVID-19 treatments. This includes:

    • all anti-virals, both anti-inflammatory and immunomodulatory
    • all cell-based therapies
    • other pharmacological treatments.

  2. Briefing and rapid action plan development

    We gather information from the collaborating organisations, companies and other sources. This may involve liaising with trial sites or company representatives. This information helps us develop briefing notes for the RAPID C-19 oversight group.

  3. RAPID C-19 oversight group review

    The collaborating organisations consider and discuss the briefing notes to identify treatments to be accelerated. Actions required could relate to:

    • potential licensing approaches
    • producing evidence summaries
    • developing commissioning policies
    • other activities needed to prepare the system to receive and deliver these treatments.

  4. Rapid regulatory signal and process

    The MHRA considers how to speed up regulatory access to the treatments identified. This includes licence extensions and revisions, as well as approaches for previously unlicensed drugs.

  5. Application of regulatory signal to patient access

    NHS England and NHS Improvement makes sure the selected treatments can be delivered. This could include developing a commissioning policy or starting an evidence review.

  6. Health technology assessment or licensing

    NICE starts the Health Technology Assessment (HTA) process. The MHRA completes any remaining licensing arrangements for each of the selected treatments.


As a result of this initiative the NHS has given patients rapid access to:

  • dexamethasone
  • hydrocortisone
  • remdesivir
  • sarilumab
  • tocilizumab.

You can read more about these treatments on our COVID-19 rapid guideline: managing COVID-19.

You can also view the full list of treatments currently being  monitored.