Evusheld turned down by NICE

[Eucalyptus22]

NICE have made their decision to not make Evusheld available on NHS as there is insufficient evidence of its effectiveness against current variants. Well I guess that's what happens if you take a year to put the drug review through the NICE process.They do recognise though that the NICE process was the wrong route for its evaluation and that Rapid C would be more appropriate. They acknowledge that something has to be done to help the immunosuppressed.

A crumb of hope on a dark day.

Information is on Blood Cancer UK website and Evusheld for UK.

Kate

[CLLerinOz Administrator]

There's a link to the NICE statement here:

healthunlocked.com/cllsuppo...

[annmcgowan]

Thank you for posting this expected but unwelcome news.

I am currently in bed with Covid day 8. The paxlovid I took upset my stomach and I was taken to hospital in isolation for 12 hours. It was a horrendous and scary experience.

The hospital did bloods, ECG, chest x ray and infused me with sotrovimab before I could go home. All involved were wonderful and I have been recovering slowly since.

As I lay in the isolation unit I couldn’t help ponder on the costs to the NHS going down the route of non prevention based on the idea evusheld is not cost effective.

Not providing preventative treatments to the vulnerable is not only dangerous but from my experience totally cost ineffective.

In my own case It took 3 contact calls to 111 and 2 paramedics and an ambulance to admission. During the 12 hours I was well attended to by many nurses, doctors specialists were contacted to guide my ongoing treatment. I would not know where or how to total up the costs but common sense tells me it’s not cost effective, let alone humane or necessary. When are this government going to see that! Never I guess is the answer. They just don’t care and have now kicked the can out of the arena altogether. Disgraceful!!!

Ann

[Eucalyptus22 in reply to annmcgowan]

Oh Ann, so sorry to hear of your experience but glad they looked after you so well. It is what we all fear and you are so right about the inhumanity of the Government's actions let alone the sheer stupidity of their decisions. How many could have benefited from Evusheld before the variant changed?The only light at the end of the tunnel is NICE's acknowledgment that their process is not appropriate for getting us protection in a timely manner. We hope that will change with Evusheld 2 but who knows.

In the meantime, take care and get better soon.

Kate

[RogerPinner in reply to annmcgowan]

Ann, really sorry to read your post. I know from previous correspondence how much you wanted and tried to get evusheld. I hope you are well on the road to recovery but how ridiculous and unnecessary that you had to go through this trauma.

I hope you won't mind if I (anonymously) pass some of your comments on to my MP. Of course it won't do any good but we have to try.

Roger

[annmcgowan in reply to RogerPinner]

Thank you your kind words Roger. I am day 9 and still not so good. Your right non of this was necessary.

Take care

Abn

[annmcgowan]

Thank you for your kind thoughts. Let’s hope things improve for us.

Ann

[stevesmith1964]

The right decision based on evidence and cost benefit. Plus it was the right route for review as a prophylactic roll out on mass would have cost in excess of 1 bn. What the should have done is approved it for use for those with additional high risk comorbidities thus the cost benefit to immunocompromised dialysis patients etc would have been easy to demonstrate

[Eucalyptus22 in reply to stevesmith1964]

The right decision at this moment in time with current variants. However, if it had been put through Rapid C as the vaccines and treatments were, many of us would have had a 'normal' life for 9 months.

The 'good' outcome from this process and the fight by the campaign group Evusheld for UK is that our voices have finally been heard and Evusheld 2 is likely to get quick approval if trials are a success.

[stevesmith1964 in reply to Eucalyptus22]

Personally I believe the campaign was flawed, focus should have been on those in most need, not a the ridiculous 500k number. I suspect that NICE will approve Evusheld 2 for a targeted cohort not mass roll out

[Lady_Lymington in reply to stevesmith1964]

So the rest of us 500,000 severely immunocompromised patients have to remain locked away until ?????? It is very sad that you consider 500k SEVERELY immunocompromised (there is a clue in these two words) people ridiculous. Have you considered the health economics of a huge number of immunocompromised people (who by the very nature of their condition are more likely to become ill with malignant and non malignant diseases), let alone the benefits of some degree of freedom? Please don’t tell us yet again how many times you have had Covid and recovered etc etc., Covid is not a lottery that many of us wish to take part in.

[Eucalyptus22 in reply to Lady_Lymington]

I agree with you Lady Lymington (nice name) and I would add that approx 500 people with covid on their death certificates are still dying each week. Obviously not just a matter of shaking it off if you are CEV. It can be a lottery.

[stevesmith1964 in reply to Lady_Lymington]

All I am saying is that the 500k figure not a viable option for a prophylactic roll out. I am one of those 500k people and like many in that cohort I am immunocompromised, but even I am on iVIG and filgastin , plus acalabrutinib.... I don't consider my self severely immunocompromised and from the data I suspect the vast majority in that 500k are in the same situation. But there is no way any government at this time would authorise mass use of a prophylactic..... 1 Bn per annum doesn't make economy or clinical sense. The campaign gave false hope to too many people

[Lady_Lymington in reply to stevesmith1964]

"I don"t consider my self (sic) severely immunocompromised" speaks volumes really, seems to be completely at odds with the vast majority of the medical establishment. Also conflicts with you being on iVIG and Filgrastim.

[stevesmith1964 in reply to Lady_Lymington]

Hi,

Having worked with NICE and in the Blood Cancer space during my 40yr pathology career , I can see from the published data of hospitalizations and deaths currently doesn't warrant mass prophylactic use. The USA who has probably 20 times more immunocompromised patients than UK only administered circa 20k shots of Evusheld. NICE hopefully will authorise use of the next prophylactic to a targeted high risk cohort within 500k, if and when the data indications a cost benifit to the tax payer. Under the current fiscal constraints on healthcare budgets I believe the bar will be very high... as it should be. I know at an individual level it's hard but NICE look at broader issues across healthcare drugs and procedures, Covid treatments improves but with drugs and general approach.

[Lady_Lymington in reply to stevesmith1964]

As a healthcare professional married to a GP I find your comments difficult to understand as it was the NHS who defined who is CEV and advised shielding for that whole group, so surely we are all the high risk cohort? If you look at any blood cancer related charity website that continue to advise us to shield if possible. I wonder how you perceive NICE will define their high risk cohort, when we are already considered clinically extremely vulnerable?

[Eucalyptus22 in reply to stevesmith1964]

If you are on Acalabrutinib then you won't produce antibodies. I guess you are less vulnerable getting ivig not available for many of us, sadly.

The cost of Evusheld for 500,000 is nothing in comparison to the total vaccine roll out or the cost of one of us landing in ICU.

False economy never mind the damage and cost to our mental health.

[stevesmith1964 in reply to Eucalyptus22]

If the data showed a both financial and clinical case for the investment, knowing NICE, they would have approved it for use in the NHS.

[Eucalyptus22 in reply to stevesmith1964]

The basis of the Evusheld for UK argument is that it should not have gone through NICE processes but instead through RAPID-C19 . Doing this has left many with zero protection. Even NICE in its statement yesterday has acknowledged that NICE is not the right process to evaluate it. The antivirals and vaccines were not judged using a financial criteria in RAPID-C19 . The main criteria was effectiveness and the government didn't bat an eyelid purchasing billions of PPE and vaccines.

[Lady_Lymington in reply to Eucalyptus22]

Well said Eucalyptus’s!

[camper2]

Not only has Evusheld been rejected in the UK (perhaps on good grounds who knows) but Covid Boosters for the immune compromised have also been stopped (as of 12 February 2023). What are the grounds for that, with Covid on the rise here?

I also posted a reply under ‘Covid booster Frequency’ too.