Question to the Department of Health and Social Care:

To ask Her Majesty's Government what assessment they have made of the efficacy of existing COVID-19 antiviral treatments for eligible patients in reducing rates of hospitalisation and death.

A range of treatment options are available to non-hospitalised patients at higher risk from COVID-19 to reduce severe disease, hospitalisation and death. These treatments are available through COVID Medicines Delivery Units and include the oral antivirals nirmatrelvir+ritonavir (Paxlovid), molnupiravir and the infusion antiviral remdesivir.

Evidence from clinical trials suggests these treatments can reduce the risk of hospitalisation. For molnupiravir, interim results found a 50% reduction in the relative risk of hospitalisation or death compared to placebo. However, updated results indicate molnupiravir reduces the relative risk of hospitalisation or death by 30% compared to placebo. Pfizer’s final analysis on the clinical trials of nirmatrelvir+ritonavir showed an 88% reduction in hospitalisation or death compared to a placebo within five days of symptom onset. No assessment of how these treatments have impacted rates of hospitalisation since December has been made.

Both molnupiravir and nirmatrelvir+ritonavir are being trialled as part of the PANORAMIC national study. Results for molnupiravir are expected in summer 2022. Recruitment for the nirmatrelvir + ritonavir opened on 11 April 2022. The study will collect further data on how these treatments work in a United Kingdom context where the majority of the population is vaccinated. It will also provide baseline information on how antivirals could be used for best clinical effect in combination with antibodies or other antiviral drugs as they become available. A 2021 trial showed that among non-hospitalised patients at high risk for COVID-19 progression, a three-day course of remdesivir had an acceptable safety profile and resulted in an 87% lower risk of hospitalisation or death than placebo.