HIQA finds insufficient evidence of effectiveness for medical interventions to reduce the risk of severe COVID-19 in the community
The Health Information and Quality Authority (HIQA) has today published its advice to the National Public Health Emergency Team (NPHET) on the effectiveness of interventions in the community setting to prevent progression to severe disease in patients with COVID-19.
HIQA has advised NPHET that there is currently insufficient evidence of effectiveness for any medical treatment aimed at reducing the risk of severe disease in patients with COVID-19 treated in the community.
HIQA suggests that GPs should receive very clear communication that, based on the current evidence, no medicines should be prescribed outside of a clinical trial aimed at preventing progression to severe COVID-19 in the community.
Dr Máirín Ryan, HIQA’s Deputy CEO and Director of Health Technology Assessment, said: “Coronavirus is a novel disease; many clinical trials are still underway and new evidence will continue to be published. However, as yet, there is insufficient evidence to support the use of any of these interventions in the community outside a clinical trial. As there is a significant risk of harm with all pharmaceuticals, it is important to evaluate the benefit, harms and appropriateness of treatment before interventions are deployed. The usual requirements for rigorous assessment of clinical effectiveness and safety and processes for reimbursement should apply.”
HIQA reviewed eight randomised controlled trials (RCTs), which studied nine pharmaceutical interventions in patients with COVID-19 who were being treated in the community setting. None of the interventions are currently authorised for the treatment of COVID-19, with only a number of them authorised for any indication by the European Medicines Agency (EMA).
This advice is accompanied by an evidence synthesis report.
Read the latest advice from the link at the top of the page.
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Notes to Editor:
- HIQA provides evidence-based advice to NPHET to inform public health policy, advice and practice in the context of COVID-19.
- NPHET asked HIQA to provide advice on the following policy question:
- "What is the emerging evidence in relation to (i) pharmaceutical and (ii) lifestyle interventions post diagnosis of COVID-19 in the community aimed at minimising progression to severe disease?"
- In response to requests from NPHET, HIQA provides advice informed by research evidence developed by HIQA’s COVID-19 Evidence Synthesis Team. This advice to NPHET is developed with expert input from HIQA’s COVID-19 Expert Advisory Group.
- The topics HIQA researches are outlined and prioritised by NPHET to ensure rapid access to the best available evidence relevant to the SARS-CoV-2 outbreak.
- HIQA’s COVID-19 Expert Advisory Group is a multidisciplinary group, comprising nominated representatives from the relevant public health and clinical specialties, methodology experts, and public representation.
- In addition to HIQA’s evidence synthesis work on behalf of NPHET, the HSE has ongoing processes for the development of clinical guidance with respect to treatment of COVID-19. Furthermore, the National Centre for Pharmacoeconomics and the HSE Medicines Management Programme provide recommendations regarding the reimbursement and use of medicines under the publicly funded healthcare system.
- The European Medicines Agency (EMA) has authorised two pharmaceuticals for the treatment of COVID-19. Dexamethasone and remdesivir are authorised for the treatment of severe disease, for example patients requiring oxygen support in the hospital setting.