OBJECTIVES: This review explores the achievements and challenges of the research to access pathway for investigational drugs for COVID-19 (RAPID C‑19). This UK multi-agency initiative includes the National Institute for Health and Care Excellence (NICE), the National Institute for Health Research (NIHR), the Medicines and Healthcare products Regulatory Agency, NHS England and NHS Improvement and the Devolved Administrations. It aims to get effective treatments for COVID‑19 to patients quickly and safely.

METHODS: NICE, working with the NIHR Innovation Observatory, identifies potentially promising treatments for COVID-19. Supported by the Scottish Medicines Consortium, NICE prepares briefings which summarise the evidence for the treatments and the key ongoing clinical trials. RAPID C-19’s oversight group meets regularly to critically appraise the latest evidence and consider the next steps needed to enable rapid patient access. If the evidence of benefit is robust, the group can then act quickly to make these treatments available promptly through expedited access mechanisms.

RESULTS: RAPID C-19 has considered briefings on 76 potential treatments to date, and continues to monitor the emerging evidence on these. Patients have had access to treatments within days of trials reporting clinical benefit, for example, dexamethasone, remdesivir, hydrocortisone, tocilizumab, sarilumab and neutralising monoclonal antibodies. Challenges have included acting on immature evidence in the context of uncertainty and the urgent need for treatments, and the evolving nature of the pandemic (for example, new variants emerging). Despite these, RAPID C-19 has responded quickly and effectively to the needs of the healthcare system.

CONCLUSIONS: Key healthcare agencies successfully work together in RAPID C‑19 to bring effective COVID-19 treatments to patients as quickly as possible. This model of collaboration could work in non-COVID settings and in other countries to speed access to beneficial treatments for patients.