Advice - continue reimbursing nirmatrelvir/ritonavir (Paxlovid®) for the treatment of COVID-19
In November 2022, nirmatrelvir/ritonavir (Paxlovid®) was included in the Medicine Reimbursement System (GVS), following the advisory report from the National Health Care Institute. This means that this medicinal product is reimbursed from the healthcare insurer’s basic healthcare package. Paxlovid® can be used for treating adults with a coronavirus infection (COVID-19) and a very high risk of severe progression of the disease. Due to the desire for the rapid availability of the product, the National Health Care Institute granted a provisional exemption for the cost-effectiveness analysis in 2022. That exemption is now definitive. The National Health Care Institute advises the Minister of Health, Welfare and Sport (VWS) to retain Paxlovid® in the GVS under the current conditions.
Coronavirus infection
In the advisory report of October 2022, the National Health Care Institute concluded that nirmatrelvir/ritonavir has added value in the treatment of adults with coronavirus infection (COVID-19) who do not require oxygen supplementation and are at a very high risk of severe disease progression. They must start the 5-day treatment as soon as possible after the coronavirus has been detected and in any event within 5 days of the onset of symptoms, as Paxlovid® will reduce the risk of hospitalisation or death for this group of patients.
Developments in the coronavirus pandemic
In June 2023, the number of infections with COVID-19 decreased significantly and thus so did the number of claims for Paxlovid®. The numbers were so much lower that it was not necessary to carry out a cost-effectiveness analysis at that time. On 13 July 2023, the National Health Care Institute therefore advised the minister of VWS to extend the provisional exemption for the pharmacoeconomic analysis to 1 January 2024. No noteworthy changes have occurred related to the coronavirus pandemic since that latest recommendation by the National Health Care Institute about nirmatrelvir/ritonavir.
Evaluation of the pharmacotherapy reassessment
The advisory report of 27 October 2022 stated that the National Health Care Institute would evaluate the need for a reassessment of nirmatrelvir/ritonavir after one year. On 13 July 2023 we recommended postponing that evaluation until January 2024 at least. The National Health Care Institute currently has no new data that suggests reassessing nirmatrelvir/ritonavir. The current situation for COVID-19 and the low number of insurance claims for nirmatrelvir/ritonavir is therefore unchanged. For that reason, the National Health Care Institute has decided that a reassessment is not needed.
Recommendations from the National Health Care Institute
The National Health Care Institute advises the minister of VWS to maintain nirmatrelvir/ritonavir in the GVS under the current conditions.