A class of laboratory-made drugs that could protect patients with high-risk COVID-19 from suffering from serious illness is being significantly underused, experts say.
Monoclonal antibodies that could neutralize SARS-CoV-2, the virus that causes COVID-19, are highly recommended for those over 65 or who have underlying medical conditions that put them at risk for serious illness. President Donald Trump received Regeneron antibody treatment shortly after he was diagnosed with COVID-19.
On Thursday, public health officials called on health professionals across the country to take advantage of the abundant supply of these monoclonal antibodies that are currently the only approved treatment that could keep Americans out of hospitals and cut by half. of hospitalization time, according to studies.
“It’s the first time during the pandemic that I remember when our resources far exceeded demand,” said Dr. William Fales of the Michigan Department of Health and Human Services, according to NBC News.
Experts say there are several reasons why monoclonal antibodies are no longer widely used. First, they should be administered shortly after a person tests positive for COVID-19 during the first week of illness. While some states, particularly Ohio, have put in place an electronic recording system that alerts health professionals if patients ’swabs turn positive, other states don’t have such a fast response system.
Second, one-hour infusions of Regeneron and Eli Lilly monoclonal antibodies should be given intravenously and appointments can last 3 to 4 hours, according to NBC News. Because patients with COVID-19 can infect other people, they should be kept in a separate room. This can severely hamper the administration of medications at a local clinic or even a doctor’s office.
Dr. Peter Chin-Hong, an infectious disease specialist at the University of California at San Francisco, cites public transportation as another obstacle to antibody treatment. Any kind of shared travel is out of the question for patients with COVID-19, and some patients cannot afford to spend half a day for treatment outside of family and work obligations, he said.
And then there’s the cost. Since the therapy is administered intravenously, a single dose costs $ 1,250, according to published reports. Although the federal government has agreed to distribute the drugs for free, the infusion alone can cost $ 1,000, which can lead to significant copayments even for insured people.
According to NPR, the federal government said it administered more than 300,000 doses of monoclonal antibody drugs to medical facilities across the country. Although Chin-Hong says its facility has only used 20% of the supply, some health systems have overcome logistical barriers to drug administration.
At Houston Methodist Hospital, doctors have opened special clinics that give 50 to 70 infusions a day to eligible high-risk patients and use the supply as quickly as they arrive. Experts say establishing similar infusion centers may be the answer to using the resources we have on hand, but it may be an unreasonable demand from some health systems that are already under the weight of the pandemic.
“If we had this pandemic under control, we could create infusion centers,” said Dr Pieter Cohen, an associate professor of medicine at the Cambridge Health Alliance, according to NBC News. “We could set up quick tests. But we don’t have those resources. We are completely inundated with sick patients. ”
Chin-Hong agrees and adds that patients eligible for monoclonal antibody treatment are generally fine. “You want to focus on sick patients,” he said.
Another factor that prevents the widespread use of this therapy may be lack of awareness. Health and Human Services Secretary Alex Azar said on Tuesday that “patients should ask their doctors or healthcare providers why they are not being offered these antibody therapies.” HHS has an online map showing some, but not all, of the sites that have received supplies of monoclonal antibodies.
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