Alabama providers no longer directly ordering monoclonal antibody treatment due to surge in use

The demand for monoclonal antibody treatments amid growing COVID-19 cases and the more contagious delta variant prompted the U.S. Department of Health and Human Services to stop allowing state medical providers to order the life-saving drug directly, and instead to require the Alabama Department of Public Health to divvy up the state’s supply among providers.

“During this transition, our highest priority will be to ensure that the ordering process for monoclonal antibodies is in place, so Alabama healthcare providers can be sent needed products as soon as possible,” State Health Officer Dr. Scott Harris said in a statement Wednesday.

The change went into effect Monday, according to a press release from ADPH, noting that the increase in COVID cases “has caused a substantial surge in the use of monoclonal antibody products.”

Monoclonal antibody treatment, manufactured by the company Regeneron, can cut the need to hospitalize a COVID patient by 70 percent, if given within 10 days of infection, according to medical experts. ADPH notes, however, that the drug is not a replacement for COVID vaccines, which have been found to be safe and effective at preventing serious illness, hospitalization and death.

The change means the federal government is now determining each state’s weekly allotment of monoclonal antibody treatment “based on cases and use on a week-by-week basis,” the release states.

“Healthcare providers must record their utilization of the products promptly in order to be eligible to receive additional shipments,” ADPH said in the statement.

HHS on Sept. 3 announced that seven Gulf Coast states would be receiving 30 percent of what they had been ordering. Those seven states have been using about 70 percent of the nation’s distribution of monoclonal antibodies, Forbes reported Friday.

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“Providers are to prioritize patients based on their risk of progression to severe COVID disease. Treatment should be given as soon as possible (within 10 days) after a close contact to a positive case of COVID-19, to patients who tested positive, and to individuals who are at high risk for disease progression to severe COVID-19,” ADPH’s statement reads.

The Alabama Department of Public Health for many weeks has been working to increase the number of providers who can administer monoclonal antibody treatments. State hospitals have seen large numbers of COVID patients, who accounted for 48 percent of Alabama’s 1,592 ICU patients. State hospitals on Tuesday had 43 more patients needing ICU care than the state had ICU beds, according to the Alabama Hospital Association. Of the 2,401 hospitalized with COVID statewide on Tuesday, 84 percent were unvaccinated.

Doctors with the Medical Association of the State of Alabama on Monday urged the federal government to increase shipments of Regeneron’s drug, not cut, them to states hard-hit by COVID, including Alabama.

“Alabama’s hospitals are full and under tremendous stress. That’s why physicians are very concerned about federal efforts that will end up limiting our supply and access to this effective treatment,” said Dr. Aruna Arora, president of the Medical Association, in a statement Monday. “We’re calling on the federal government to help us provide more of this treatment – not less – so we can save lives and keep COVID patients out of the hospital.”

Alabama has the fourth-lowest percentage of fully-vaccinated residents in the nation, at 40.2 percent, behind only Idaho, West Virginia and Wyoming, according to the Centers for Disease Control and Prevention.

Alabama hospitals have reported 557 COVID deaths in the 10 days ending Tuesday, and averaged 55 deaths daily during that time, according to Alabama Hospital association data compiled and shared by East Alabama Health.

It can take the Alabama Department of Public Health weeks to review medical records to confirm those deaths were due to COVID-19, so the department’s confirmed daily death toll lags behind actual daily deaths.

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