Federal allocation system for COVID-19 monoclonal antibody treatment working well in Iowa

Iowa hospitals report they’re having no problems getting enough doses of the injections that prevent people from developing severe illness from COVID-19.

About a month ago, federal officials started a new distribution system for the doses, putting states in charge of distributing the monoclonal antibody treatments.

Doctors in Eastern Iowa have provided the infusions to hundreds of patients and, so far, they’ve seen good results.

“The research is showing that it is really helping prevent the patient from developing severe disease,” said Dr. Rami Boutros, a pediatrician and executive medical director for University of Iowa Health Care-Iowa River Landing.

“What we’ve seen in our data, in general, is the patients who received that treatment are less likely to be hospitalized,” he said.

The treatments provide antibodies to fight COVID-19 in people who’ve been exposed to or diagnosed with the virus.

The treatments — approved by the U.S. Food and Drug Administration under an emergency use authorization — trigger an immune response to infection that prevents severe illness, hospitalization and death.

The treatment is free for patients.

How it works

On Sept. 13, federal officials changed allocation rules so that health care providers no longer could order monoclonal antibody treatments directly from the manufacturer, AmerisourceBergen.

Instead, the U.S. Department of Health and Human Services put states in charge of allocating the drugs, similar to the method used when the treatment was first approved in November 2020.

Federal officials determine the number of doses to be sent to each state each week after looking at the number of COVID-19 cases in a state and the use of the treatment by doctors in each state.

Iowa Department of Public Health officials said the process helps “ensure consistent availability of these drugs for current and future patient care.”

“At this time, providers have shared they are able to meet current patient care needs,” IDPH spokeswoman Sarah Ekstrand said in an email.

The public health department is prioritizing allocations based on high-risk patient counts, as well as the inventory of doses and treatment rates of providers.

“To date, no provider has declined an allocation,” Ekstrand said.

So far, so good

Local providers say they’ve faced no challenges with the new distribution system.

“There has not been any impact on Mercy’s ability to administer therapy to patients. The supply is meeting demand,” said Jamie Sinclair, the pharmacy director at Mercy Medical Center in Cedar Rapids.

Nationwide, use of this treatment has increased significantly in the midst of the latest surge in COVID-19 cases, largely driven by the delta variant.

Iowa also has seen a stable, increasing trend in its weekly allocation, Ekstrand said.

UnityPoint Health-St. Luke’s Hospital officials in Cedar Rapids reported they used more monoclonal treatments in August — 101 — since providers began administering the infusions in January. The previous high had been 25 infusions in January.

Dr. Dustin Arnold, St. Luke’s chief medical officer, said that may be in part due to an increasing awareness of the treatment from local health care providers.

“Doctors are doing a good job getting in contact with us when they need it,” Arnold said.

When it’s used

Research has shown monoclonal antibody treatments are highly effective in preventing serious hospitalization in people who are given the treatment within seven to 10 days after symptoms begin.

Arnold noted the treatment becomes less effective after 10 days.

Hospital providers say they determine the best candidates for the infusion based on individual patients’ risk factors.

Patients who are unvaccinated, which increases their risk for developing severe COVID-19 infection, are more likely to receive the treatment, Arnold said.

UIHC

Among those most vulnerable to severe COVID-19 complications are transplant patients.

Iowa’s only transplant center is at the University of Iowa Hospitals and Clinics in Iowa City, where transplant patients are offered the antibody treatment if they test positive for COVID-19.

“We also have other patients who are not in our system, but they heard about the treatment, so they reach out,” UIHC’s Medical Director Boutros said.

“If they meet the criteria, we are getting them into our system, so we have really developed a slick system to get (patients) in and in a proactive way.”

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