August 22, 2022
Monoclonal antibody changes
The Federal government has exhausted the supply of Bebtelovimab they purchased for use during the pandemic. Lilly will now make the make the monoclonal available commercially, though it is still under the FDA’s Emergency Use Authorization. At the present time, Lilly does not plan to pursue full approval from the FDA. LMH Health would like to continue to offer monoclonal antibody infusions to qualified patients on a thirty day trial basis, as it has appeared to be effective in preventing qualified COVID patients from becoming ill enough to be admitted to the hospital.
The logistical and financial implications of providing Bebtelovimab is being determined. Third-party payers have not yet finalized whether prior authorizations will be needed and what the payment will be. This is certainly a concern, given the drug’s EUA status - not full approval. The commercial price for the drug is $2,100 per vial.
- Paxlovid remains the first recommendation if the patient is medically eligible. It is vital that the referring provider review all drug interactions to see if the patient might qualify. Managing interacting medications may allow a patient to receive Paxlovid. Pharmacists are available to help review potential drug interactions, including medications that might be safely held for a time to be able to receive Paxlovid.
- Remdesivir is the second recommended option. Prior authorization is not required and LMH Health has an adequate supply available. This is a three consecutive day regimen, with each dose taking an hour to infuse.
- The first dose will typically be given in the emergency department.
- The second and third doses will be scheduled in TPC, with careful coordination between the ED and TPC.
- Bebtelovimab will be used if neither Paxlovid or Remdesivir are possible. Vials that were received by LMH through the EUA will be reserved for patients qualifying for patient assistance programs. A small number of vials will be purchased for commercial use. LMH will be monitoring payer requirements and reimbursement over the next thirty days and monitoring for any logistical and financial challenges with this product.
Questions? Email LMH Health Pharmacy director Chris Lawrenz or call 785-505-6445 for more information.