Fast access to COVID medicines for people with blood cancer

Antibody and antiviral treatments for people with blood cancer (updated 22 April 2022)

People with blood cancer, which does include people with a MPN (who are taking medication for their MPN – aspirin alone does not count) can now access the latest covid treatments after a positive lateral flow test, rather than having to wait for a PCR test.

If you are not taking any medication for your MPN (aspirin alone does not count) you are currently not eligible for the covid treatments, and therefore will not be eligible for ongoing free covid tests. However, if you do develop covid symptoms, you should still take a covid test. If it’s positive, contact your hospital team, GP or call 111 and ask whether you should have a telephone assessment for the new covid treatments.

If you have MF (myelofibrosis), and whether or not you take medication, you may be eligible for the covid treatments and free covid tests. See the information below for the country you live in to access these treatments.

REMEMBER – MPNs are BLOOD CANCERS and this is the simplest way to refer to them when talking with the NHS or healthcare professionals.

Treatments for COVID-19 are free of charge on the NHS. The NHS will never ask for your bank account or card details, or ask you to pay for treatment.

These treatments are available across the UK, although the process for how to access them varies in the different countries – we explain the process in each country below. If you are worried about your risk and access to the new treatments, talk to your doctor or medical team.

After your positive test, you would need to have a telephone consultation with a healthcare professional, to find out whether you can have one of the treatments.

Fast access to covid medicines for people with blood cancer

From 10 February 2022, across the UK, some people with blood cancer aged 12 and above who test positive for covid may be eligible for:

sotrovimab
Paxlovid
remdesivir
molnupiravir

These medicines aim to stop covid becoming severe and to prevent hospitalisation or serious illness in those most at risk.

After your positive test, you would need to have a telephone consultation with a healthcare professional, to find out whether you can have one of the treatments.

These treatments are available across the UK, although the process for how to access them varies in the different countries – we explain the process in each country below.

Antibody and antiviral treatments for people with blood cancer

How to be assessed for the new covid treatments

Keep a stock of rapid lateral flow tests at home. You can order boxes online.

If you get covid symptoms, take a lateral flow test as soon as possible. If it’s positive, you may be able to have a new antibody or antiviral treatment. If it’s negative, but you have covid symptoms, get a PCR test (it’s possible to get a false negative on the lateral flow test, but a PCR test will show positive if you are infected).

Keep a list of your medical conditions and all your medications handy, including details of your haematologist – this will help you during any telephone assessments for new treatments.

England

Many people with blood cancer (MPN) have been sent a letter about accessing the new treatments, and a priority PCR test kit to keep at home. There were problems with the roll-out and many people with blood cancer did not get their letters and PCR tests.

But as of 10 February 2022, you no longer need a PCR test to get access to the new covid treatments – you only need a positive lateral flow test and a telephone assessment.

This means if you get symptoms of covid, you should take a lateral flow test as soon as possible. If it’s positive, you’ll need to log your positive test online or by calling 119. This should trigger an automatic phone call from a Covid Medicines Delivery Unity (CMDU) within 24 hours to ask about your symptoms and discuss the new treatments.

Due to the previous problems that many people with blood cancer (MPN) have had being contacted about new treatments, we would advise that as soon as you get a positive lateral flow test result, you contact 111, your GP and/or your hospital team, as any of these can refer you urgently for a telephone assessment with the CMDU. Make sure you have contact details for your GP surgery and hospital team’s ‘out of hours’ service, in case you test positive at the weekend or any time outside their normal working hours. Keep a list of all your medical conditions and all your medications handy, including details of your haematologist and your MPN medication, this will help you during any telephone assessments for the covid treatments.

Whoever you speak to, tell them you have a BLOOD CANCER and then tell them which MPN you have and that you have tested positive for covid and you think you’re eligible for the new treatments, you can refer them to the links below.

If you test positive for covid and you are unable to speak to anyone (the CMDU team, your hospital team, your GP or NHS 111), email your details to england.contactus@nhs.net so they can get the right CMDU to get in touch.

Although a PCR test is not needed to access the new treatments now, it is still a good way of monitoring your covid and tracking the virus, so we would encourage you to also get a PCR test. Waiting for your PCR results will not delay your telephone assessment.

Scotland

Many people with blood cancer were sent a letter about accessing the new treatments. It said that if you get covid symptoms, you should have a priority PCR test, because you may be eligible for the new covid treatments.

But as of 10 February 2022, you’ll no longer need a PCR test to get access to the new covid treatments – you only need a positive lateral flow test and a telephone assessment.

This means if you get symptoms of covid, you should take a lateral flow test as soon as possible. If it’s positive, you’ll need to log your positive test online or by calling 119.

You will need to report your positive covid result to your Health Board. You can find contact numbers for each Health Board here. Whoever you speak to, tell them you have a BLOOD CANCER and then tell them which MPN you have and that you have a positive covid test, and that you think you are eligible for the new covid treatments. You can refer them to this page. You could also get advice by calling 111, your hospital team or your GP.

Make sure you have contact details for your GP surgery and hospital team’s ‘out of hours’ service, in case you test positive at the weekend or any time outside their normal working hours. Keep a list of all your medical conditions and all your medications handy, including details of your haematologist and your MPN medication, this will help you during any telephone assessments for the covid treatments.

You could also show them the links below.

Wales

Many people with blood cancer were sent a letter about accessing the new treatments. It said that if you get covid symptoms, you should get a PCR test as soon as possible, because you may be eligible for the new covid treatments.

But as of 10 February 2022, you’ll no longer need a PCR test to get access to the new covid treatments – you only need a positive lateral flow test and a telephone assessment.

This means if you get symptoms of covid, you should take a lateral flow test as soon as possible. If it’s positive, you’ll need to log your positive test online or by calling 119. This should trigger an automatic phone call from your local Health Board within 24 hours to ask about your symptoms and discuss the new treatments.

Due to the previous problems that many people with blood cancer (MPN) have had being contacted about new treatments, we would advise that as soon as you get a positive lateral flow test result, you contact 111 or your Health Board to ask about getting the telephone assessment for new treatments. You can find contact numbers for each Health Board here. You could also get advice by calling your hospital team or your GP.

You could also show them the link below.

government web page about accessing new covid treatments

Northern Ireland

In Northern Ireland, if you get covid symptoms, previous advice was to get a PCR test as soon as possible, because you may be eligible for the new covid treatments.

But as of 10 February 2022, you’ll no longer need a PCR test to get access to the new covid treatments – you only need a positive lateral flow test and a telephone assessment.

This means if you get symptoms of covid, you should take a lateral flow test as soon as possible. If it’s positive, you’ll need to log your positive test online or by calling 119. This should trigger an automatic phone call from the NHS within 24 hours to ask about your symptoms and discuss the new treatments.

Due to the previous problems that many people with blood cancer have had being contacted about new treatments, we would advise that as soon as you get a positive lateral flow test result, you contact 111 or your Trust to ask about getting the telephone assessment for new treatments. You could also get advice by calling your hospital team or your GP.

NI Direct information about accessing the new treatments in Northern Ireland.

If you are told you are not eligible for new treatments

Not everyone with blood cancer (MPN) will be eligible for the new treatments, even after a telephone consultation. In this case, you could think about joining the PANORAMIC trial. This trial gives you a 1 in 2 chance of getting molnupiravir (half the people on the trial get molnupiravir and half don’t).

You can sign up to the PANORAMIC trial yourself if you have covid symptoms, a positive PCR test, and you are aged 50 or over, or 18 to 49 with an underlying condition.

Whether you have been sent a letter about this or not, if you get covid symptoms, take a covid test as soon as possible. If you get a positive result, follow the instructions for your country above, to find out whether you should access the new covid treatments.

What are the different covid treatments and how are they are given?

All of these treatments have been found to be safe and effective at reducing the risk of hospitalisation and death in people with blood cancer with covid. Which treatment you have (if any) will be based on a personal assessment with a qualified healthcare professional about the different benefits and risks.

Sotrovimab (Xevudy)

antibody treatment
given into a vein (intravenously), so you’d need to attend a medical clinic to have treatment
can be used in people aged 12+
79% relative risk reduction of hospitalisation or death
lab work suggests it’s effective against the Omicron variant
should be given within 5 days of covid symptoms starting
more about sotrovimab

Paxlovid

antiviral treatment (made up of nirmatrelvir and ritonavir).
taken as tablets at home
can be used in people aged 18+
88-89% relative risk reduction of hospitalisation or death
should be given within 5 days of covid symptoms starting, but this can be extended to 7 days if needed
more about Paxlovid

There are lots of health conditions and other medicines that can interact with Paxlovid. With some, you shouldn’t take Paxlovid at all, with others, your doctor should consider this with you before making a decision. The drugs include some cancer drugs, immunosuppressants, painkillers, drugs for infections, blood clot prevention drugs, hormonal contraceptives, and other medicines. So any decision about starting Paxlovid would need to follow a discussion about your type of blood cancer (MPN), any other health issues and what other medication you are on.

Remdesivir

antiviral treatment
given into a vein (intravenously), so you’d need to attend a medical clinic to have treatment
can be used in people aged 18+, and sometimes 12+ when give ‘off-label’
87% relative risk reduction of hospitalisation or death
should be given within 7 days of covid symptoms starting

Molnupiravir (Lagevrio)

antiviral treatment
taken as tablets at home
can be used in people aged 18+
30-48% relative risk reduction of hospitalisation or death
should be given within 5 days of covid symptoms starting
more about molnupiravir

There are some antibody treatments being researched, which could prevent covid in people with blood cancer.

Tixagevimab and cilgavimab (Evusheld) – monoclonal antibodies from AstraZeneca’s PROVENT trial

For the first time, a long-acting antibody treatment has been found to prevent covid in people who take it.

A trial called PROVENT tested two antibodies, tixagevimab and cilgavimab (Evusheld) to see if they could prevent serious illness in people at high risk from covid. The trial was run by the drug manufacturer AstraZeneca and the antibody combination was originally known as AZD7442.

In the trial, two thirds of people were given the antibody treatment, and one third weren’t. The groups were then monitored to see how many people in each group got covid. The aim was to see whether giving this treatment to people could prevent them getting covid.

The trial found that there was a 77% reduced risk of developing symptomatic covid in people who had the treatment.

In people treated with Evusheld, there were no cases of severe covid or covid-related deaths. In the group who weren’t treated, there were three cases of severe covid and two deaths.

The trial involved over 5,000 people who did not have covid at the time and had not already had covid vaccines. Approximately 43% of participants were 60 years and over. More than 75% of participants had other health conditions that put them at a higher risk from covid, including people with immunosuppression due to disease or medical treatment.

What is Evusheld?

Evusheld is a combination of two long-acting antibodies called tixagevimab and cilgavimab. These are called human monoclonal antibodies. They were taken from blood donations from other people who had covid themselves and developed the antibodies.

This treatment is thought to give protection for up to 12 months. It is given using two injections into a muscle. In the trial, people tolerated the drugs well and there were no serious concerns about side effects.

AstraZeneca have said they aim to submit their trial results to the regulators (MHRA in the UK) to seek approval to make this drug available to people. If the MHRA approves its use, the government and health departments will need to plan whether and how to roll out this medicine to people in the UK.

Update: Evusheld and omicron

The PROVENT trial was completed before the omicron variant appeared. Two recent studies in the US and UK suggest that Evusheld may be effective against it, but these studies were conducted in the lab, not in humans, and have not yet been reviewed by other experts.

More data is needed to confirm the level of protection Evusheld will offer people against the omicron variant.

The situation is being monitored updates will be issued as soon as we hear more. See the original press release about this trial, and a more recent press release from December 2021.

How do antibody and antiviral treatments work?

Antibody treatments for covid

An antibody treatment can give your body the covid antibodies it needs to fight the illness. The antibodies are injected straight into the bloodstream. They will stick to the surface of coronavirus and stop it getting inside our cells and making us ill. They also act as a distress signal, telling other cells to come and help destroy the virus.

This is particularly important for people with blood cancer (MPN), whose immune systems may not be able to develop its own covid antibodies after vaccination.

Antiviral treatments for covid

Antivirals work slightly differently from antibodies. They interfere with the way the coronavirus replicates and reproduces in our body.

On their own, viruses can’t make more versions of themselves. What makes them effective, is their ability to enter our own cells and hijack a toolbox in our cells that allows them to increase their numbers. Antivirals stop this from happening, and the less virus there is in our body, the lower the risk of more severe illness.

The UK government has said that finding antiviral medicines that can be taken at home (as tablets) will be one of the main ways to protect people from covid after vaccination.

We expect both antivirals and antibodies to be good options for people with blood cancer (MPN), as results from clinical trials have been promising.

COVID vaccinations – our latest data suggests that the 3^rd primary dose is REALLY important, so please get it. Once you have had 3 doses you will then need a 4^th booster dose.

How to get your 3^rd primary dose if you live in:

England – you can book an appointment via the NHS website, you will need to take a letter from your consultant/GP to confirm to that you should have a 3^rd primary dose, if you have not received a letter, details on how to obtain one can be found here.

Scotland – information can be found here.

Wales – information can be found here.

Northern Ireland – information can be found here.

How do I book my booster (fourth dose)?

Information about this can be found using the links above.

The situation is changing, we will update you when we have new information.

Fast access to COVID medicines for people with blood cancer

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