Antiviral services across Wales – Healthcare Professionals site

Antiviral services across Wales

– Information for Healthcare Professionals

The supply of treatments for COVID-19 for the most vulnerable individuals across Wales who have not been admitted to hospital is now co-ordinated by GP practices and out-of-hours services.

The National Antiviral Service Cymru (NAVS) has now been decommissioned and each local health board is responsible for providing treatment for their citizens.

Information for Healthcare Professionals

The following information and resources are aimed at healthcare professionals. Members of public can access information about the antiviral services from this site.

NICE guidance on COVID-19 treatments

NICE evidence-based recommendations on nirmatrelvir plus ritonavir (Paxlovid▼®), sotrovimab (Xevudy▼®) and tocilizumab (RoActemra®) for treating COVID-19 [TA878] were updated on 01 May 2025. The evaluation reviews the clinical and cost effectiveness of treatment options for mild COVID-19 and for severe COVID-19. The recommendations can be accessed via the NICE website.

NICE recommendations on molnupiravir (Lagevrio▼®) for treating mild to moderate COVID-19 [TA1056] were published on 16 April 2025. This evaluation of the clinical and cost effectiveness and recommendations can be accessed via the NICE website.

The All Wales Primary Care Antimicrobial guidelines were updated in March 2026, removing sotrovimab as a treatment option. These guidelines can be accessed via the AWTTC website.

WMAS have published guidance to help identify and manage potential drug interactions with COVID-19 treatments. The University of Liverpool COVID-19 Drug Interactions checker is a comprehensive resource to support decisions on whether COVID-19 treatments can be taken concurrently with a patient’s regular medicines.

Eligibility Criteria

The nationally agreed eligibility criteria are defined in the NICE guidance NG191 and technology appraisals TA878 and TA1056. The definitions of those considered at increased risk of progression to severe COVID-19 are found in NICETA878.

Patient Group Directions (PGDs)

The national COVID-19 treatment PGD templates are available for adaptation by local health boards.

COVID-19 “Rebound” associated with Paxlovid▼® treatment

Cases of COVID-19 rebound following treatment with nirmatrelvir/ritonavir have been noted. The NAVS team have been involved in highlighting case reports, which you can read more about in this Journal of Infection letter.

Other useful resources

Change history

10 Mar 26

COVID-19 drug interactions supporting material updated to version 3. Statement on sotrovimab no longer being used in Cardiff and Vale UHB removed.

22 Oct 25

Statement on sotrovimab no longer being used in Cardiff and Vale UHB added.

18 Sep 25

COVID-19 drug interactions supporting material updated.

22 May 25

COVID-19 drug interactions supporting material added. Referral portal section removed.

19 May 25

Information on NICE guidance and eligibility criteria updated.

16 Jan 25

CAVUHB referral form link removed.

05 Sep 24

Decision aid details removed and University of Liverpool Covid-19 DI checker link inserted. Details of Panoramic Trial, and Extended use and Interim Clinical Commission sections removed.

01 Jul 24

Xevudy®▼ shelf-life extension details added.

07 Aug 23

Links to online referral portals updated.

24 Jul 23

Eligibility criteria updated.

18 Jul 23

Sotrovimab PGD template updated.

11 Jul 23

Decision aid for Paxlovid use updated.

08 Jun 23

Updated to reflect new service provision across the Health Boards rather than a single national service.

22 Apr 23

PGD templates updated.

18 Apr 23

Eligibility criteria updated.

29 Mar 23

NICE guidance [TA878] added.

22 Dec 22

Expiry date extension information added.

26 Oct 22

Paxlovid PGD updated. Decision aid link added.

25 Oct 22

Paxlovid PGD updated. Treatment options evidence review added.

07 Sep 22

NAVS Referral Pathway added, eligibility criteria and PGDs updated.

11 Jul 22

Webinar link added.

01 Jul 22

Eligibility criteria and PGDs updated.

22 Jun 22

COVID-19 “Rebound” article added.

06 Apr 22

Published.

Cymraeg