Around 1.4 million more people could be eligible for antiviral treatment Paxlovid if they test positive for Covid after final draft guidance from NICE widens access.

And they will also be eligible for free lateral flow tests, available from participating pharmacies, and should take a test as soon as they have symptoms, even if mild, NICE said.

Community Pharmacy England (CPE) described the move as 'sensible' and said that it would be discussing the implications for the lateral flow device service with NHS England.

The change follows a partial review of the evidence that identified additional groups of people who are at increased risk of severe Covid-19.

Under the recommendations, Paxlovid (nirmatrelvir plus ritonavir) will also be available to people aged 70 years and over as well as those with a body mass index greater than 35 kg/m2.

Patients with diabetes and heart failure will also be eligible as well as those on the organ transplant waiting list.

The eligibility is in addition to the 3.9 million people who were already identified as being as increased risk of progression to severe illness if they were infected with Covid-19, NICE said.

Those who are eligible can get free lateral flow tests  from participating pharmacies and should take a test as soon as they have symptoms, even if mild, NICE reiterated before calling their GP, NHS111 or hospital specialist if they test positive.

Helen Knight, director of medicines evaluation said: ‘Our review of the evidence on the use of Paxlovid has found it offers value for money for a wider group of patients.

‘This is good news for people who may contract Covid-19 in the coming months and will help alleviate pressure on the health service.

She added: ‘Although we are no longer in a pandemic, Covid-19 is still circulating and we are pleased that more people at risk of severe disease can benefit from Paxlovid.’

Alastair Buxton, director of NHS services at CPE told The Pharmacist: 'Widening the patient cohort eligible for Paxlovid is sensible. This change should have consequences for the scope of the LFD service, which we will discuss with NHS England.'

Community pharmacies began delivering Covid antiviral treatments last year, when ICBs took on responsibility for delivery of treatments from the Covid-19 Medicines Delivery Units (CMDUs).

But contractors condemned the payment for the scheme, at a £2.50 per item reimbursement fee, plus the single activity fee (SAF), as ‘derisory’ and ‘unsafe’.

In October, NHSE recommended that community pharmacies maintain stocks for one or two courses of Covid oral antivirals Paxlovid and Lagevrio, depending on usual demand, to dispense against prescriptions immediately.

UK public health officials have reported rising levels of winter bugs in the past week with rates of flu, Covid-19 and norovirus continuing to rise.

The latest figures also show a rise in Covid-19 hospitalisations in the last week of 2023 as well as patients admitted to ICU with complications of the virus.

A version of this article first appeared on our sister title Pulse.