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 being co-ordinated by NHS 111 Wales.

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 [TA878] published on COVID-19 treatments

On 29 March 2023, NICE published evidence-based recommendations on casirivimab plus imdevimab (Ronapreve▼®), nirmatrelvir plus ritonavir (Paxlovid▼®), sotrovimab (Xevudy▼®) and tocilizumab (RoActemra®) for treating COVID-19 [TA878].

This 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.

A decision aid (only accessible from an NHS Wales networked computer) has been developed to help maximise Paxlovid▼® use.

Interim Clinical Commissioning Policy Treatments

Update The Interim Clinical Commissioning Policy is no longer in effect. Please refer to the current NICE guidance.

A decision aid (only accessible from an NHS Wales networked computer) has been developed to help maximise Paxlovid▼® use.

Eligibility Criteria

The nationally agreed eligibility criteria are available in this table.

Referral Portal

Where a healthcare professional considers a patient may be eligible for treatment, they can refer them for review by their local antiviral service via an online portal. Staff from Cardiff and Vale UHB please use this link, healthcare professionals from other health boards, please use the NHS111 portal.

Extended use of antivirals beyond labelled expiry dates

The Department of Health and Social Care (DHSC) and pharmaceutical company Pfizer have extended the shelf life of specified batches of Paxlovid▼® (nirmatrelvir 150mg and ritonavir 100mg) film-coated tablets.

The DHSC and pharmaceutical company MSD have extended the shelf life of specified batches of Lagevrio▼® (molnupiravir) 200mg hard capsules.

Some expiry dates have been extended following assessment by the Medicines and Healthcare products Regulatory Agency (MHRA). The list of specified batches can be found on the GOV.UK website:

The following Direct Healthcare Professional Communications have also been circulated regarding these changes:

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

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