COVID-19: new treatments

Vaccines remain the primary defence against COVID-19, but today (8th December 2021) the UK Government has announced that it has also made available other new treatment options for COVID-19 for eligible groups of patients.

Thousands of the UK’s most vulnerable people will be among the first in the world to access cutting-edge antiviral and antibody treatments. These new treatments are used in the earliest stages of infection and often taken at home. They must be administered as soon as possible after a confirmed COVID-19 positive PCR test has been received.

A national study ‘PANORAMIC’, run by the University of Oxford, has now launched and is recruiting around 10,000 UK patients at risk of serious illness from COVID-19 to have the opportunity to take the antiviral molnupiravir at home after receiving a positive PCR test.

Those at highest risk who test positive for the virus – for example, people who are immunocompromised, cancer patients or those with Down’s syndrome – will also be able to access either molnupiravir or the novel monoclonal antibody Ronapreve outside of the study from 16th December 2021.

Molnupiravir has shown in clinical trials to reduce the risk of hospitalisation or death for at-risk, non-hospitalised adults with mild to moderate COVID-19 by 30% and Ronapreve reduced the risk by 70%.

Commenting on the announcement, Alastair Buxton, Director of NHS Services at PSNC said:

“PSNC absolutely supports the PANORAMIC trial to test the impact that life-saving antiviral and antibody treatments could have when used in the community.

“If the findings of the trial are positive, there is no doubt that community pharmacy teams would be the best people to distribute the oral antivirals – making sure people have easy access to critical medicines, safely, is what we do best. And pharmacies have proven, through the success of the Pandemic Delivery Service, that they can do this in a COVID-safe way that gets medicines to people in their homes.

“DHSC and NHSE&I are still in the planning stages of how distribution might work pending the trial results, and PSNC is actively engaged in those discussions which are considering the various logistical challenges that apply to the timely distribution of the products.”

The PANORAMIC study

The PANORAMIC study, which is currently for molnupiravir, has been launched today to allow researchers to gather further data on the potential benefits this treatment brings to vaccinated patients, and will help the NHS to develop plans for rolling out the antiviral to further patients next year.

It’s open to anyone in the UK, provided they:

• receive a positive PCR test;
• feel unwell with symptoms of COVID-19 that started in the last five days; and
• are aged 50 and over or 18 to 49 with an underlying health condition that puts them more at risk of severe COVID-19.

If eligible, people who receive a positive PCR test will be contacted by the study team or a local healthcare professional, for example their GP, to sign up to the trial. Alternatively, people can sign up themselves through the study’s website.

Taking part in the study will require participants to complete a daily diary for 28 days through the PANORAMIC website or receive a phone call from the trial team on days 7, 14 and 28 to speak about their symptoms. The first set of results from the trial are anticipated in early 2022.

Targeted deployment of molnupiravir and Ronapreve

For treatment access outside of the study, those in the highest risk group will be informed by the NHS if they have a condition that will make them eligible to receive these treatments, should they test positive for COVID-19. The eligible cohorts have been determined by an independent expert group commissioned by the Department of Health and Social Care and included in a clinical policy agreed by all four Chief Medical Officers in the UK.

These patients will be able to keep a PCR test at home from NHS Test and Trace to support rapid testing, so they can access the treatments as soon as possible after symptoms begin.

Eligible patients who receive a positive test will be assessed over the phone by a clinician from an NHS COVID Medicines Delivery Unit (CMDU), who will review and discuss with the patient what the most appropriate treatment would be for them.

Those being prescribed a monoclonal antibody treatment will be invited to attend the CMDU, while those receiving molnupiravir can either get someone to collect it for them or have it delivered to their home.

The Government has secured 480,000 courses of molnupiravir from Merck Sharp and Dohme (MSD).

Further information

Download a summary of information on the new treatments

Letter to general practices/community pharmacies: deployment of COVID-19 treatments for highest risk non-hospitalised patients (9th December 2021)

Interim Clinical Commissioning Policy: Neutralising monoclonal antibodies or antivirals for non-hospitalised patients with COVID-19 (9th December 2021)