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Covid-19: Recovery trial set to lose funding as proposal to examine flu drugs is rejected

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1809 (Published 19 July 2022) Cite this as: BMJ 2022;378:o1809
  1. Elisabeth Mahase
  1. The BMJ

Funding for the UK’s Randomised Evaluation of Covid-19 Therapy (Recovery) trial—which has been instrumental in finding cheap and effective covid-19 treatments—is to end in October, the trial’s co-leads have said.

The team’s funding proposal to study treatments for severe influenza within Recovery has also been rejected by the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI). The bodies said this was because “funding for a flu platform should be competed through a fair and open competition.”

The Recovery team has said the cost of studying influenza drugs on top of covid-19 treatments would be low, and highlighted that Roche has provided the antiviral drugs free of charge and that the protocol has already been approved by the NIHR and the Medicines and Healthcare Products Regulatory Agency. They added that there is no relevant funding competition that they can currently apply for.

Trial co-leads Martin Landray and Peter Horby told The BMJ that they are now going to request that they be allowed to use the unspent funding from their current grant to continue for another year and complete the studies of current covid-19 drugs. Meanwhile, they are looking for alternative sources of funding to support the study of influenza treatments.

The Recovery trial was launched early in the pandemic and by July 2020 had found the first lifesaving covid-19 treatment—dexamethasone. The cheap and widely available steroid was found to cut deaths by a third among covid-19 patients admitted to hospital who needed ventilation and by a fifth among patients receiving oxygen only.1 Since then, it has found two more effective treatments—tocilizumab2 and baricitinib.3 The trial has recruited nearly 50 000 participants and has 199 sites around the world.

In a statement, Horby, director of the University of Oxford’s Pandemic Sciences Institute, and Landray, professor of medicine and epidemiology at the University of Oxford, said, It is the case that the current grant is to end at the end of October and that NIHR have requested the return of any unspent funding. The unspent funding would be sufficient to continue the Recovery study of covid-19 for at least a further year and would allow completion with a study of the current drugs.”

They said they will soon be requesting a no cost extension. The NIHR and UKRI have said grantees can apply for “costed or no cost extensions” for existing work, in the case of delays.

Commenting on the situation, London School of Hygiene and Tropical Medicine professor of pharmacoepidemiology Stephen Evans said, “Recovery has provided the best data on effects of treatments for covid-19 and it has demonstrated that its infrastructure works quickly, efficiently, and produces clear results. Losing such a resource would be a major problem for the world, not just the UK.”

Evans said Recovery should not only be allowed to use the unspent money to continue the trial platform, but should also have its funding extended to cover further covid-19 and non-covid treatments.

“Randomised trials are vital in this field, and while, as a pharmacoepidemiologist I think observational data do have value, they cannot compensate in many circumstances for lack of randomisation,” he said.

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