Lifesaving and Free, but Still Few Takers

Aug. 1, 2022 – Evusheld, the medication used to prevent COVID-19 infection in patients at high risk, has issues. Namely, supplies of the potentially lifesaving drug outweigh demand.

At least 7 million people who are immunocompromised could benefit from it, as could many others who are having cancer treatment, have had a transplant, or are allergic to the COVID-19 vaccines. The medication has protective antibodies against SARS-CoV-2, the virus that causes COVID, and helps the body protect itself. It can slash the chances of getting infected by 77%, according to the FDA.

And it’s free to eligible patients (although there may be an of out-of-pocket administrative fee in some cases).

Despite all those lifesaving benefits, fewer than 25% of available doses have been used.

To meet demand, the Biden administration secured 1.7 million doses of the medicine, for which the FDA granted emergency use authorization in December. But as of July 25, 793,348 doses have been ordered by the administration sites, and just 398,181 doses have been reported as used, a spokesperson for the Department of Health and Human Services says.

Each week, a certain number of doses from the 1.7-million dose stockpile is made available to state and territorial health departments. States have not been asking for their full allotment, the spokesperson says.

Now, the Department of Health and Human Services and AstraZeneca have taken steps to increase awareness of the medication and access to it:

  • On Wednesday, the department announced that individual providers and smaller sites of care that don’t currently get Evusheld through the federal distribution process via its Health Partner Order Portal can now order up to three patient courses of the medicine. These can be ordered online.
  • Health care providers can use the department’s COVID-19 Therapeutics Locator to find Evusheld in their area.
  • AstraZeneca has launched a new website with educational materials and says it is working closely with patient and professional groups to inform patients and health care providers.
  • A direct-to-consumer ad was launched June 22 and will run in the U.S. online and on connected TV (Yahoo, Fox, CBS Sports, MSN, ESPN) and will be amplified on social and digital channels through year’s end, an AstraZeneca spokesperson says.
  • AstraZeneca set up a toll-free number for providers, 833-EVUSHLD (833-388-7453).

Evusheld includes two monoclonal antibodies, tixagevimab and cilgavimab. The medication is given as two shots, one after the other, during a single visit to a doctor’s office, IV center, or other health care facility. The antibodies bind to the SARS-CoV-2 spike protein and prevent the virus from getting into human cells and infecting them. It’s authorized for use in children and adults ages 12 and older who weigh at least 88 pounds.

Research found the medication decreases the risk of getting COVID-19 infection for up to 6 months after it is given. The FDA recommends redosing every 6 months, with the doses of 300 milligrams of each monoclonal antibody. In clinical trials, Evusheld, compared with a placebo, reduced the risk of COVID-19 illness with symptoms by 77%.

Doctors monitor patients for an hour after giving Evusheld to look for allergic reactions. Other possible side effects include cardiac events, but they are not common.

Doctors and Patients Weigh In

Doctors – and patients – from the United States to the United Kingdom and beyond, are questioning why the medication is underused, while praising the recent efforts to expand access and increase awareness.

The U.S. government may have underestimated the amount of communication needed to spread awareness of the medication and its applications, says infectious disease specialist William Schaffner, MD, a professor of preventive medicine at Vanderbilt University School of Medicine in Nashville.

Many doctors who need to know about it, such as transplant doctors and rheumatologists, are outside the typical public health communications loop, he says.

Eric Topol, MD, director of the Scripps Research Translational Institute and editor-in-chief of WebMD’s sister site Medscape, has taken to social media to bemoan the lack of awareness.

Another infectious disease expert agrees. “In my experience, the awareness of Evusheld is low amongst many patients as well as many providers,” said Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore.

There were scarce supplies at first, he says, and some hospital systems gave priority access to those who were the most immunosuppressed.

“Also, many community hospitals never initially ordered Evusheld – they may have been crowded out by academic centers who treat many more immunosuppressed patients – and may not currently see it as a priority,” Adalja says. “As such, many immunosuppressed patients would have to seek treatment at academic medical centers where the drug is more likely to be available.”

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