everthing

Life-saving and free, but still few users

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Editor’s Note: Find the latest COVID-19 news and advice in Medscape’s Coronavirus Resource Center.

Evusheld (AstraZeneca), a drug used to prevent SARS-CoV-2 infection in high-risk patients, has problems, namely that supplies of the potentially life-saving drug outweigh demand.

At least 7 million people who are immunocompromised could benefit, as could many others undergoing cancer treatment, transplantation or allergies to the COVID-19 vaccines. The drug has lab-produced antibodies to SARS-CoV-2 and helps the body protect itself. According to the US Food and Drug Administration (FDA), it can reduce the chance of contamination by 77%.

And it’s free for eligible patients (although there may be an out-of-pocket administrative fee in some cases).

Despite all those life-saving benefits, less than 25% of the available doses have been used.

To meet demand, the Biden administration has secured 1.7 million doses of the drug, which was approved by the FDA for emergency use in December 2021. However, as of July 25, 793,348 doses have been ordered by the application sites and only 398,181 doses have been reported as used, a spokesperson for the Department of Health and Human Services (HHS) said. Medscape Medical News.

Each week, a certain number of doses from the stock of 1.7 million doses are made available to the state and territorial health departments. States have not asked for their full allocation, the spokesman said Thursday.

Now, HHS and AstraZeneca have taken a number of steps to increase awareness and access to the drug.

  • On Wednesday, HHS announced that individual healthcare providers and smaller healthcare facilities that do not currently receive Evusheld through the federal distribution process through the HHS Health Partner Order Portal can now order up to three patient courses of the drug. These can be ordered online.

  • Healthcare providers can use the HHS’s COVID-19 Therapeutics Locator to locate Evusheld in their area.

  • AstraZeneca has launched a new website with educational materials and says it is working closely with patient and professional groups to inform patients and healthcare providers.

  • A direct-to-consumer ad was launched on June 22 and will run online and on TV in the US (Yahoo, Fox, CBS Sports, MSN, ESPN) and will be boosted on social and digital through the end of the year. channels, an AstraZeneca spokesperson said. Medscape Medical News.

  • AstraZeneca has set up a toll-free number for carriers: 1-833-Evusheld.

Evusheld contains two monoclonal antibodies, tixagevimab and cilgavimab. The medication is administered as two consecutive intramuscular injections during a single visit to a doctor’s office, infusion center, or other healthcare facility. The antibodies bind to the SARS-CoV-2 spike protein and prevent the virus from entering and infecting human cells. It is approved for use in children and adults ages 12 and older who weigh at least 88 pounds.

Studies have shown that the medication reduces the risk of contracting COVID-19 for up to 6 months after administration. The FDA recommends repeating the dosing every 6 months with the doses of 300 mg of each monoclonal antibody. In clinical trials, Evusheld reduced the incidence of symptomatic COVID-19 disease by 77% compared to placebo.

Doctors monitor patients for allergic reactions for one hour after Evusheld administration. Other possible side effects include cardiac events, but they are uncommon.

Doctors and patients weigh in

Doctors ― and patients ― from the US to the UK and beyond wonder why the medication is underused, while praising recent efforts to expand access and raise awareness.

The U.S. federal government may have underestimated the amount of communication needed to increase awareness of the medication and its uses, said infectious disease specialist William Schaffner, MD, a professor of preventive medicine at Vanderbilt University School of Medicine, Nashville.

“HHS has not made a major educational effort to promote it,” he told Medscape Medical News.

Many physicians who need to be aware of this, such as transplant physicians and rheumatologists, are outside the typical public health circle of communication, he said.

Eric Topol, MD, director of the Scripps Research Transational Institute and editor-in-chief of Medscape, has brought to social media complain about the lack of awareness.


Another infectious disease expert agrees. “In my experience, awareness of Evusheld is low among many patients and many health care providers,” says Amesh Adalja, MD, a senior scientist at the Johns Hopkins Center for Health Security in Baltimore.

“Initially, there were scarce supplies of the drug, and certain hospital systems that were eligible for treatment based on degree of immunosuppression and only the most immunosuppressive were proactively approached for treatment.

“In addition, many community hospitals never ordered Evusheld initially — they may have been supplanted by academic centers that treat many more patients with immunosuppression and may not see it as a priority at the moment,” Adalja said. Medscape medical news. “As such, many patients with suppressed immune systems should seek treatment in academic medical centers where the drug is likely to be available.”

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