1 Recommendations

1.1 Tixagevimab plus cilgavimab is not recommended, within its marketing authorisation, for the pre‑exposure prophylaxis of COVID‑19 in adults who are not currently infected with SARS‑CoV‑2 and who have not had a known recent exposure to someone infected with SARS‑CoV‑2, and:

  • who are unlikely to have an adequate immune response to COVID‑19 vaccination, or

  • for whom COVID‑19 vaccination is not recommended.

Why the committee made this recommendation

The results of clinical studies of tixagevimab plus cilgavimab suggest it reduces infection with SARS‑CoV‑2 (the virus that causes COVID‑19) compared with no preventative treatment. But these studies were done early in the pandemic when different variants of the virus were circulating. More recent studies done in laboratories report that tixagevimab plus cilgavimab is unlikely to prevent infection with most of the variants circulating when this guidance was produced.

Because of the lack of evidence of clinical effectiveness, the cost-effectiveness estimates for tixagevimab plus cilgavimab are highly uncertain. They are also likely to be much higher than what NICE considers an acceptable use of NHS resources. So, tixagevimab plus cilgavimab is not recommended. Further research is recommended to address some of the uncertainties in this rapidly changing disease area (see section 4).

  • National Institute for Health and Care Excellence (NICE)