As omicron variants finish sweeping across the U.S., states with scarce supplies of monoclonal antibody treatments continue to use two treatments that federal health officials warn are no longer suitable for the highly contagious version of the virus that causes covid-19 .Antibody Therapy Now most recommended Sotrovimab from GlaxoSmithKline and Van Biotech, which is in short supply.
New ineffective therapeutic uses produced by Regeneron Pharmaceuticals and Eli Lilly are the highest in a dozen states. Those states include several southern states with the lowest vaccination rates in the U.S., as well as California, which ranks in the top 20 nationally for fully vaccinated residents, according to a KHN analysis of federal data. Many hospitals and clinics are still infusing expensive treatments—often charging hundreds of dollars per session—that public health officials now say are almost certainly not useful.
This is because omicron is almost completely dominant, 99.5% of new covid infections In the U.S. during the week ended Jan. 15, according to the U.S. Centers for Disease Control and Prevention.
This week’s update highlights that Guidelines The National Institutes of Health now recommends sotrovimab as the primary monoclonal treatment for the disease.
Unless providers are sure they are still treating patients infected with the delta variant, they should not use others, said Dr. Mark McClellan, director of the Duke-Margolis Center for Health Policy and a former FDA commissioner. Former administrator of CMS. The delta variant is Fewer and fewerFor example, Louisiana has 3%, California has 7%, and Ohio has 10%.
“There is no medical justification based on the evidence for Regeneron and Eli Lilly’s products,” McClellan said.
Determining which patients are infected with the delta and omicron variants is complicated, said Dr. Christian Ramers, director of population health and infectious disease specialist at Family Health Center in San Diego.
His clinic is one of the few locations in the country that uses laboratory-screening positive PCR covid tests that can tell if patients have delta and omicron infections, and then treat them accordingly. “Otherwise, you’re giving a false sense of security to patients who are being treated,” Ramers said. “I don’t think it’s ethical and it goes against the principle of doing no harm.”
Overall, US hospitals used about 72,000 doses of the Regeneron and Lilly monoclonal antibody therapies from Jan. 5 to Jan. 18. The latest data From the Department of Health and Human Services. Data on hospital-level use of sotrovimab are not yet available on the HHS website and are available more recently than other products.
By comparison, from Dec. 22 to Jan. 4, the hospital used about 153,000 treatments of Regeneron and Lilly. From Aug. 26 to Sept. 8, they used about 169,000 sessions, approaching the height of the delta surge.
On January 19, the hospital still had about 295,000 doses of the Regeneron and Lilly treatments on hand.
Across the country, the federal government is distributing Over 50,000 courses sotrovimab weekly, although it is still in short supply. The Biden administration has agreed to buy about 100 million doses, including about 600,000 pledged in March, GlaxoSmithKline officials said.
KHN’s analysis shows that from January 5 to January 18, Michigan, Florida, Indiana, Missouri, Louisiana, California, Oklahoma, Kansas, Georgia, Ohio, New York and Mississippi used the most Regeneron and Lilly treatments, respectively.
In Florida, where more than 5,200 outdated treatment sessions were used in those two weeks, Republican Gov. Ron DeSantis said he did not believe Regeneron and Lilly’s products would be ineffective against omicron.In Florida, omicron accounts for 97% of cases As of January 20; Delta accounted for 3%.
“We’ve had doctors give both drugs to omicron patients who say their symptoms are resolved,” he said in remarks Jan. 5 by spokeswoman Christina Pushaw.
Federal health officials managing the allocation of monoclonal antibody therapies suspended shipments of the Regeneron and Lilly therapies on Dec. 23 after lab tests showed they were less effective on the surged omicron variant than the delta variant.But a Biden administration Shipping will resume on December 31After complaints from DeSantis and some doctors believe these therapies can also help people in the Delta variant stick to places.
Regeneron itself has said its antibody treatment is ineffective against the omicron variant. It contains more than 30 mutations in the virus’s spike protein, which make the variant better able to evade monoclonal antibody treatment.
“It really doesn’t make sense at this point, unless there’s some other potential secondary gain, political pressure, or maybe the vendor isn’t really exposed to a different scale of reality,” Lamers said.
Earlier this month, HHS officials said shipments of the three monoclonal antibody treatments would continue through Jan. 31 despite the rising proportion of omicron cases. A department spokesman in the background said the agency would continue to assess “any impact on the distribution of COVID-19 treatment.”
Monoclonal antibody treatments are laboratory-based molecules that mimic the body’s immune response to infection. They are most commonly given by intravenous infusion, but some can be given by injection. The federal government has agreed to buy millions of doses of Regeneron and Lilly for about $2,100 per dose. The drug is provided free to consumers, although hospitals and clinics do charge a fee for administering the drug and monitoring patients during the process.
Other treatments expected to be effective against omicron in high-risk, non-hospitalized patients include AstraZeneca’s Evusheld, a long-acting injectable monoclonal antibody for immunocompromised people, and Gilead Sciences ) of remdesivir (FDA-approved) as a three-day infusion. New oral antivirals are also expected to be effective, although they also remain in short supply.
Suppliers in several states that continue to use Regeneron and Lilly’s products have cited various reasons. Some said they thought the delta infection continued to spread locally; others said they were desperate to try something.
Officials in Michigan, which used more than 5,800 doses of Regeneron and Lilly products in the last two weeks, and California, which used more than 3,400 doses in the last two weeks, allowed health care providers to use their clinical judgment in which treatment to prescribe.
But omicron is rampant in Mississippi, where less than half of residents are fully vaccinated, and state health official Dr. Thomas Dobbs has called for the treatments to be stopped.
“Based on the distribution of omicron and delta, we will advise clinicians and physicians not to use these products now,” he said in a recent press conference.
At the Lammers Clinic in San Diego, providers dispense scarce doses of monoclonal antibody therapy only when they are confident they will help. That meant sending batches of positive PCR tests to a lab near Irvine, where they were screened to see if one of the three target genes, a known marker of omicron infection, was not detected.
Patients infected with the delta variant are able to be treated with Regeneron’s product REGEN-COV, preserving sotrovimab for the growing number of omicron cases, said Pauline Lucatero, the clinic’s director of care.
“Looking my patients in the eyes and seeing fear, just fear, all I can tell them is that we believe this treatment works and we’re going to do everything we can to save as many people as possible,” she said.
Philip Rees, assistant professor of journalism at California State University, Sacramento, contributed to this report.
KHN (Kaiser Health News) is a national newsroom that provides in-depth news coverage on health issues.Along with policy analysis and polling, KHN is one of the top three operating programs in the U.S. KFC (Kaiser Family Foundation). KFF is a donating non-profit organization that provides information on health issues to the state.
