A class of drugs made in the laboratory that could protect high-risk COVID-19 patients from becoming seriously ill is being significantly underused, experts say.
Monoclonal antibodies that can neutralize SARS-CoV-2, the virus that causes COVID-19, are highly recommended for people over 65 or who have underlying medical conditions that put them at risk for serious illness. President Donald Trump received treatment with Regeneron antibodies shortly after being diagnosed with COVID-19.
On Thursday, public health officials asked 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 hospital stay in half, according to studies.
“This is the first time during a pandemic that I remember when our resources far exceed 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 soon after the result of the COVID-19 test on a person during the first week of the disease. While some states, notably Ohio, have put in place an electronic registration system that alerts healthcare professionals if patient swabs are positive, other states do not have a rapid response system in place.
Second, the one-hour infusions of monoclonal antibodies Regeneron and Eli Lilly must be administered intravenously, and consultations can last between 3 to 4 hours, according to NBC News. Since COVID-19 patients can infect others, they must be kept in a separate room. This can seriously 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 transport as another obstacle to antibody treatment. Any kind of shared travel is out of the question for COVID-19 patients, and some patients cannot spend half a day for treatment away from family and work obligations, he said.
And then there is the cost. Because the therapy is administered intravenously, a single dose costs $ 1,250, according to published reports. Even though the federal government has agreed to distribute the drugs for free, the infusion alone can cost $ 1,000, which can result in heavy copayments, even for insured people.
According to the NPR, the federal government said it had distributed more than 300,000 doses of monoclonal antibody drugs to medical facilities across the country. Although Chin-Hong says his facility used only 20% of the supply, some health systems have overcome logistical obstacles to administering the drugs.
At Houston Methodist Hospital, doctors have opened special clinics that administer 50 to 70 daily infusions to eligible high-risk patients and are using the supply as fast as it arrives. Experts say that the creation of similar infusion centers may be the answer to the use of the resources we have, but it may be an irrational demand for some health systems that are already burdened by the weight of the pandemic.
“If we had this pandemic under control, we could establish infusion centers,” said Dr. Pieter Cohen, associate professor of medicine at Cambridge Health Alliance, according to NBC News. “We could set up the quick test. But we don’t have those resources. We are completely inundated with sick patients. “
Chin-Hong agrees, adding that patients eligible for treatment with monoclonal antibodies are generally fine. “You want to focus on sick patients,” he said.
Another factor that is preventing the widespread use of this therapy may be the lack of awareness. Health and Human Services Secretary Alex Azar said on Tuesday that “patients should ask their doctors or healthcare professionals why they are not receiving these antibody therapies.” HHS has an online map that displays some, but not all, of the locations that received supplies of monoclonal antibodies.
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