UPMC to allocate COVID drug
UPMC plans to allocate limited doses of a new monoclonal antibody combination called Evusheld, designed to prevent COVID-19 infections in immunocompromised individuals who may not respond as well to vaccination.
Dr. Erin McCreary, director of antimicrobial stewardship innovation and infectious diseases pharmacist, explained the health system's plans to distribute the treatment at a virtual news conference on Thursday afternoon.
“This is a really big deal for our patients who have been anxiously waiting for another way to protect themselves from COVID-19,” McCreary said. “Our patients with compromised immune systems may not respond as robustly to COVID-19 vaccination as other patients. While these patients should absolutely still be vaccinated, it's very exciting for us to have an additional long-acting antibody medication that serves as an extra layer of protection for some of our most vulnerable patients.”
Evusheld was developed by AstraZeneca, and authorized through emergency use authorization by the FDA Dec. 8. It is approved for adults and children 12 years of age and older weighing at least 88 pounds who are not currently infected with COVID-19 and have not been recently exposed to a positive case.
The FDA advises that Evusheld is not recommended as a substitute for vaccination for those for whom vaccination is recommended, but the treatment can serve as pre-exposure prevention for people who may not mount an adequate immune response to vaccines, such as transplant patients and cancer patients.
Distribution of the drug to healthcare providers in the United States only began this week, McCreary said. UPMC expects to initially receive very limited doses of Evusheld, and plans to administer it to eligible patients as quickly as possible through a lottery system.McCreary said that the health system received 456 doses so far, which makes up about one-fourth of the doses allocated to Pennsylvania by the federal government in total.“What we know from our experience and from our ethical principles that we've practiced for the last two years and beyond is that 'first-come first-serve' is not ethical because people who are more likely to access health care would come to you first,” McCreary said. “So, you're disadvantaging your patients that are less likely to access care, which could be your sickest of the sick from our more disadvantaged communities.”McCreary added that those from disadvantaged communities tend to be disproportionately affected by COVID-19.“We truly feel the only way to do this right is to put all those patients in a lottery and give certain weights for patients that are disproportionately affected by disease in order to structurally account for that, and then run a random number generator lottery to determine which patients will be allocated the drug,” she said. “That's exactly what we did. We contacted those patients, and we started yesterday and we are going through today to schedule them their appointments to come in and receive this drug.”UPMC will continue to use this method until enough supply is available to openly offer it to every eligible patient, she said.“Until we have that, we will distribute it in this fashion to be transparent, to be equitable, to be fair and to treat our most vulnerable,” McCreary said.Qualifying patients will be contacted and scheduled by UPMC, and there is no call-in line for the medication at this time. UPMC plans to continue to administer Evusheld until every eligible patient who wants it has received it, as supply allows.
