What is the UK’s Covid-19 drug armoury like amid rising infection levels?

Drug ApprovalVaccineEmergency Use Authorization
What is the UK’s Covid-19 drug armoury like amid rising infection levels?
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Source: Pharmaceutical Technology
The UK Medicines and Healthcare products Regulatory Agency (MHRA) has approved nine vaccines to treat the virus, with a range of antivirals available to patients to reduce the severity of symptoms and help manage the disease. Credit: Shutterstock/ZorroGabriel.
Covid-19 cases in the UK have been picking up since November, with a 39% increase in positive tests in the last seven days alone.
Research shows that the UK is currently in a seasonal spike of Covid-19 infections, with November to April estimated to exhibit high disease activity.
Yet another vaccine was recently added to the UK’s fully approved line-up. In October 2023, Novavax’s prototype, Nuvaxovid, gained full marketing authorisation from the MHRA for use in individuals aged 12 and older. An updated vaccine was approved on 24 January. Nuvaxovid was originally greenlit under an emergency use authorisation in 2022.
Novavax CEO John Jacobs said in a 24 January statement announcing full approval of the updated vaccine: “Today’s MHRA authorisation is recognition of the role our vaccine can have in protecting the British public against Covid-19 this year.”
Nuvaxovid’s inclusion marked the entry of another protein sub-unit-based vaccine to those available in the UK. It joins long-standing vaccines present from near the beginning of the pandemic, including Pfizer/BioNTech’s Comirnaty and Moderna’s Spikevax, both RNA vaccines, and Oxford/AstraZeneca’s viral vector-based Vaxzevria. Janssen and Valneva also have MHRA-approved vaccines.
GSK/Sanofi’s VidPrevtyn Beta, another protein-based variant Covid-19 vaccine, was approved for use as a booster in December 2022. HIPRA Human Health’s Bimervax was approved in August 2023, becoming the ninth Covid-19 vaccineCovid-19 vaccine authorised by the MHRA.
Amid signs that Covid-19 will become a seasonally spiking virus, the UK’s autumn booster programme aims to reduce hospitalisations in those most at risk from sivere disease. In the current programme, those aged 65 years and over are eligible, along with those who meet certain criteria.
Omicron BA.2.86 has emerged as the dominant variant throughout winter. While early indications show that it is no more dangerous than other variants, data is limited and the UK Health Security Agency (UKHSA) continues to monitor its circulation.
The UKHSA’s chief medical advisor, Professor Susan Hopkins, said in September 2023: “The autumn vaccination programme started this month, and this new [variant] data shows once again how important it is that the most vulnerable among us are fully vaccinated in order to receive the greatest possible protection.”
The UKHSA reported that last autumn’s booster programme resulted in patients being 53% less likely to be admitted to hospital with the disease in the 2–4 weeks following vaccination.
Away from prevention and looking at the treatment outlook, more than a million patients will soon gain access to Pfizer’s antiviral pill Paxlovid (nirmatrelvir/ritonavir). The drug is already recommended to an estimated 3.9 million people who meet certain criteria and, following recommendation by the National Institute of Care and Excellence, a further 1.4 million patients will be eligible.
Alongside Paxlovid, the NHS offers Veklury (remdesivir) from Gilead Sciences and MSD’s Lagevrio (molnupiravir). GSK/Vir Biotech’s Xevudy (sotrovimab) is a monoclonal antibody given to Covid-19 patients on the NHS who are unsuitable for antivirals.
Approved by the MHRA in December 2021, Paxlovid has been a source of high revenue for Pfizer. The antiviral saw peak global sales in 2022, totalling $18.9bn. Annual sales of the drug have since declined as the number of Covid-19 infections has fallen.
Paxlovid is currently transitioning to the US commercial market. The US commercial price for Paxlovid has been set at nearly $1,400 per five-day course – nearly triple what the US Government paid.
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