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Pleading for more use of a Covid drug

Coronavirus Daily
Bloomberg

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Pleading for more use of a Covid drug 

U.S. health officials are pleading for more use of Covid-19 antibody therapies from Eli Lilly and Co. and Regeneron Pharmaceuticals Inc. that have been plagued by logistical issues, lack of efficacy data and insufficient reimbursement.

The antibody treatments, touted by President Donald Trump and once feared to be subject to rationing because of demand, have instead been underused. As little as 5% of the supply available was being used in some areas in December, and utilization is now about 20% to 25% of regimens distributed to states, according to a Health and Human Services Department spokesperson.

The U.S. has more than $4.2 billion in supply agreements for millions of doses of antibody therapies for Covid-19, including a $2.6 billion deal with Regeneron clinched this week. Frustrated health officials seek wider use of the drugs that, like Covid vaccines, were developed at top speed in hopes of keeping patients out of hospitals and potentially preventing the severely ill from overwhelming the nation's health system.

Janet Woodcock, a long-time FDA official who's likely to play a role in President-elect Joe Biden's administration, urged hospitals and health centers to make the investments to administer the drugs.

"We really feel it is worth it to go to the effort, set up the infusion centers, have as many infusions to high-risk people as possible and decrease the burden to the health-care system," Woodcock, who's also therapeutics lead for Operation Warp Speed, said Thursday at a briefing.

The Lilly and Regeneron antibody treatments mimic proteins that are typically produced by the body to fend off the virus. Emergency FDA clearances in November made them the first drugs authorized for use in non-hospitalized patients. They're intended specifically for older individuals or those with chronic medical conditions, who are at high risk of progressing to severe Covid-19.

But the authorizations were based on small, early-stage trials, a point of contention for clinicians who say insufficient data makes it difficult to recommend the drugs to patients. And the government's distribution plan to date has relied heavily on hospitals. Beset by the pandemic, they are not yet getting paid for performing infusions because of delays in Medicare reimbursement and payment from commercial health insurers.

"It is a problem at a time when hospitals are financially strapped, as are many others in health care," Nancy Foster, the American Hospital Association's vice president of quality and patient safety policy, said in an interview. "It needs to be resolved quickly."

Already this year, Lilly is seeing a significant improvement in uptake of its antibody, called bamlanivimab, over last year, according to Chief Financial Officer Joshua Smiley. Still, he said, friends ask him where to find the drugs for their loved ones with Covid. 

"We should be able to make a bigger impact than we are making, and certainly we'll be able to make a bigger impact in February and January and so on," Smiley said.--Emma Court and Riley Griffin

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