Mon. Oct 18th, 2021

Newsletter: The road to recovery

When Selene contracted Rico Covid-19, she was worried because she had diabetes, which put people at greater risk of contracting serious diseases. But like hundreds of thousands of unvaccinated Americans, she went to a health center last month for a monoclonal infusion antibodies and felt better within a few days.

“One of the nurses told me it was the same infusion that President Trump gave when he contracted Covid-19 and he got better,” Rico told the Financial Times.

“That was another reason why I felt confident about the treatment: they were not going to drive the president crazy.”

Demand for antibody treatments by Regeneron and Eli Lilly has increased 20-fold since mid-July as a deadly wave of Covid-19 swept the country, according to the government data. U.S. sales of Sotrovimab, a similar product manufactured by GlaxoSmithKline, tripled in August compared to July, the company said.

Rising awareness of the treatments, the opening of new antibody infusion centers and an increase in infections in states with a low vaccination rate are driving demand and offering manufacturers billions of dollars in revenue.

But it has also led to a weakening in supply in some countries, prompting a debate over who should have access to the expensive antibody treatments and whether it is a tool for people who do not want the vaccines.

Last month, the federal government took control of the distribution of its stock of AmerisourceBergen antibody treatments over concerns about unfair dose allocation.

Data shows that seven southern states received more than half of the doses in the week from 13 September.

The governors of Florida and Texas, who are both opposed to vaccine mandates and priced against antibodies, criticized the federal government’s policy shift and ordered extra supplies of Sotrovimab directly to address an expected shortage.

‘There was a wrong guidance that says: monoclonal antibodies are great and vaccines are not that good. And it really tipped things in the wrong direction, ”says Eric Topol, director of the Scripps Institute for Translational Institute.

‘Many people who are anti-wax think they can only get the antibodies if they get sick. But it does not work that way. ”

Bar graph of% of population fully vaccinated shows vaccination rates in key states

Health experts warn that antibody treatments only work well if used shortly after a Covid-19 infection and do not provide the type of long-term protection against the virus that vaccines provide. They may play an important role in preventing people at greatest risk from becoming seriously ill, but should not be used as a first line of defense against the virus, they say.

In addition to the risks of relying on Covid-19 treatments rather than vaccines, the medicine also costs much more. The U.S. government is spending $ 2,100 on each dose of Regeneron’s antibody cocktail – a combination of casirivimab and imdevimab – under a $ 2.9 billion deal agreed last month to help address the shortage of treatments.

Pfizer initially charged the U.S. government $ 19.50 for a single dose of its vaccine, while Moderna charged the U.S. government about $ 15 per jab.

The World Health Organization has asked Regeneron to lower its prices and provide more equitable access to its antibody worldwide.

‘Ironically, the vaccine is much cheaper and more effective in general. But we are in the middle of the crisis and as long as the resources are available to pay for these drugs, we have to use them, ”says Jason Gallagher, clinical professor at Temple University School of Pharmacy.

He said it is understandable, if problematic, that so many people feel they can be happy and avoid serious Covid-19 without a vaccine. Yet they still need to gain access to potentially life-saving antibodies, Gallagher said.

But access to antibodies in some parts of the US is difficult due to the increase in demand.

Regeneron CEO Leonard Schleifer blames the supply shortage on policymakers and health professionals, who initially avoided promoting antibody treatments over concerns that people would be deterred from being vaccinated.

“The world was very focused on vaccines and treatments, which were similarly ignored,” he told the Financial Times.

“We should have taught people that vaccines are the best line of defense. But if you get sick and do not respond to the vaccine, or if you have not been vaccinated, there was an effective treatment, especially if given early.

Schleifer said when the Delta wave hit in August, the number of treatments Regeneron distributed in the U.S. rose to 250,000 a week, up from about 1,000 in June. The government had to sit down with the company as soon as possible to plan demand in 2022, he added.

Health experts say the development Merck’s antiviral pills may reduce the demand for antibodies next year. Late-stage data show that molnupiravir reduces hospitalization and mortality rates by 50 percent. But the pills have not yet been approved for use by regulators, which means they are not yet able to solve the current treatment deficiencies.

At the family health centers in San Diego, where Rico received her infusion, the stock ran out almost last week.

“It got too close last week with just 100 doses in the fridge,” said Christian Ramers, a specialist in infectious diseases at the center.

He said the center follows national guidelines that put those at greatest risk because of the Covid priority, which means vaccinating is at the forefront. But as a “public health-oriented person,” it just makes no sense to use such a remedy on people who could have avoided infection with a much cheaper shot, Ramers added.

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