Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many drugs which have received regulatory approval since January 2019 are only available through the NHS and cannot be prescribed by private physicians.
Answered by Lord Kamall
All authorised medicines and vaccines regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) can be prescribed by a prescribing clinician as a private prescription. However, the decision to place a medicine or vaccine on the private market is a matter for the individual manufacturer. Information on drugs which have received the MHRA’s approval and solely available through the National Health Service is not held centrally.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what legislation requires Public Health England to provide antiviral treatments for COVID-19 to only those people with particular health conditions.
Answered by Lord Kamall
The pharmaceutical companies producing antivirals have not made these treatments commercially available to the private health care sector in the United Kingdom. These products have been procured by the Department and are only available through the National Health Service.
The Department has agreed contracts with MSD and Pfizer to ensure that the UK has sufficient antiviral medication to treat those who are likely to benefit. There is no legislation which sets out the patient cohorts to receive antiviral treatments for COVID-19. Clinically eligible cohorts have been determined by an independent expert group commissioned by the Department and included in a clinical policy agreed by the UK Chief Medical Officers.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what contractual arrangements they have, if any, with pharmaceutical companies that prevent the sale of antiviral drugs for COVID-19 by private clinicians.
Answered by Lord Kamall
The pharmaceutical companies producing antivirals have not made these treatments commercially available to the private health care sector in the United Kingdom. These products have been procured by the Department and are only available through the National Health Service.
The Department has agreed contracts with MSD and Pfizer to ensure that the UK has sufficient antiviral medication to treat those who are likely to benefit. There is no legislation which sets out the patient cohorts to receive antiviral treatments for COVID-19. Clinically eligible cohorts have been determined by an independent expert group commissioned by the Department and included in a clinical policy agreed by the UK Chief Medical Officers.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of (1) the use of (a) molnupiravir, and (b) Paxlovid, as antiviral treatments for COVID-19 in other countries, and (2) the rules for administering such treatments, when considering how to administer and distribute those treatments in England.
Answered by Lord Kamall
Molnupiravir and nirmatrelvir + ritonavir (co-packaged as Paxlovid) are available for the treatment of COVID-19 in multiple countries. The Antivirals and Therapeutics Taskforce is engaging with international organisations and nations to share learning on the use and deployment of therapeutics and antivirals, including molnupiravir and Paxlovid.
Eligibility for oral antivirals has been determined by an independent expert group commissioned by the Department and included in a clinical policy agreed by the United Kingdom Chief Medical Officers. This policy is based on evidence that individuals with specific health conditions are more likely to progress to severe disease. In the community, eligible patients have access to oral antivirals through COVID Medicines Delivery Units in England, with equivalent arrangements in Scotland, Wales and Northern Ireland. In addition, Paxlovid is available to eligible patients who contract COVID-19 whilst in hospital. We are continuing to monitor international use and administration of these treatments to inform the clinical policy.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 28 March (HL7225), why decisions on the deployment of antiviral treatments for COVID-19 for people beyond the highest risk groups are tied to the outcomes of the PANORAMIC study; and when they expect such decisions to be made.
Answered by Lord Kamall
We are ensuring that deployment of antiviral treatments is supported by comprehensive data on clinical and cost-effectiveness to ensure healthcare professionals and patients have full confidence in prescribing and receiving these treatments.
The PANORAMIC study was established following a recommendation from an expert clinical panel. The expert panel advised that additional information should be gathered on which patients would benefit most from antiviral treatments in the United Kingdom, given high rates of vaccination. Previous trials have predominantly used unvaccinated participants.
Results for the first antiviral treatment, molnupiravir, are likely to be available in summer 2022, when a decision on clinical access will be made by an expert panel. The second antiviral treatment, Paxlovid, is expected to enter the PANORAMIC study in April 2022.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 24 March (HL7023), why antiviral treatments for COVID-19 are not commercially available; and what assessment they have made of the effectiveness of such treatments.
Answered by Lord Kamall
The pharmaceutical companies producing antivirals have not made these treatments commercially available to the private health care sector in the United Kingdom. The supply of the COVID-19 oral antiviral treatments approved by the Medicines and Healthcare products Regulatory Agency is commercially available to the Government for National Health Service patients and the devolved administrations. Pharmaceutical companies are responsible for the commercial decisions on the availability of their products.
The Merk Sharp and Dohme clinical trial of molnupiravir showed that the drug reduces the relative risk of hospitalisation or death by 30%. Pfizer’s trial of nirmatrelvir+ritonavir showed an 89% reduction in hospitalisation or death compared to a placebo. The PANORAMIC national study will inform our understanding on how oral antiviral treatments perform in the UK, where the majority of the population is vaccinated. This will inform future decisions on access for patients in the UK.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 24 March (HL7023), why they are retaining stocks of COVID-19 antiviral treatments.
Answered by Lord Kamall
The Government has secured 4.98 million patient courses of oral antiviral treatments. As a result, there are supplies of oral antivirals molnupiravir and nirmatrelvir+ritonavir held in the United Kingdom with regular deliveries to ensure sufficient treatment for patients. These are available to eligible patients in the community at highest risk of developing severe disease through COVID Medicines Delivery Units in England and equivalent arrangements in Scotland, Wales and Northern Ireland. In addition, nirmatrelvir + ritonavir is available to eligible patients who contract COVID-19 whilst in hospital.
We continue to monitor clinical trial results to understand which patient cohorts may benefit from oral antivirals, including the PANORAMIC national study. The results will inform our understanding of the performance of oral antivirals where the majority of the population is vaccinated and future decisions on patient access in the UK.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how many COVID-19 patients are currently in hospital; whether those patients are being given antiviral treatments to aid their recovery; and if so, what is the average length of time it takes patients receiving such treatments to be cured.
Answered by Lord Kamall
As of 28 March 2022, the number of patients currently in hospital with COVID-19 is 17,685. A range of treatments are available to these patients, including antivirals. Eligible patients admitted to hospital for reasons not related to COVID-19 and subsequently test positive are able to access nirmatrelvir + ritonavir (Paxlovid), an oral antiviral treatment or remdesivir, an intravenous antiviral. For patients whose immune system means they are at higher risk of COVID-19, the antiviral treatments molnupiravir, nirmatrelvir + ritonavir and remdesivir are available in the community to reduce the risk of hospitalisation and death.
Approximately 120,000 treatments have been provided in England, of which 53,000 were antivirals administered to hospitalised patients. The data requested on the average time for patients receiving antivirals to be cured is not held centrally.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 21 March (HL6991), what body was responsible for the decision that antiviral treatments for COVID-19 can only be prescribed by a clinician within a COVID Medicine Delivery Unit and are not available for general practice prescribing and purchase directly from pharmacies; when this decision was taken, and why.
Answered by Lord Kamall
The decision was made by NHS England and NHS Improvement prior to December 2021, when the first COVID Medicine Delivery Units were launched. Any decisions on the longer-term deployment of COVID-19 treatments beyond the highest risk groups will be subject to the outcomes of the PANORAMIC study on the effectiveness of antivirals in the United Kingdom population.
Asked by: Baroness Rawlings (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord Kamall on 15 March (HL6625), why antiviral treatments for COVID-19 can only be prescribed by a clinician within a COVID Medicine Delivery Unit and cannot be prescribed by private physicians.
Answered by Lord Kamall
The supply of COVID-19 oral antivirals is not yet commercially available, with the current United Kingdom stocks held by the Government. As there is no commercial supply of antivirals, private physicians are not able to prescribe antivirals to non-hospitalised patients.