Despite high demand for Evusheld — AstraZeneca's antibody cocktail meant to prevent COVID-19 in vulnerable patients — physicians' confusion over the drug have made them hesitant to prescribe it, The New York Times reported March 6.
The Times reports an estimated 80 percent of available doses of Evusheld are sitting unused in warehouses, pharmacy and hospital shelves. Of the 1.7 million doses purchased by the federal government — enough to treat 850,000 people — nearly 650,000 were ready to be distributed to states as of last week, a senior official told the Times. Still, just 370,000 have been ordered, with fewer than a quarter of those actually used.
Based on interviews with physicians, patients and government officials, the Times found a number of reasons the drug may be unused.
First, some providers are hesitant to prescribe the drug because they're confused on how to use it, since most antibody treatments are used after someone is diagnosed with COVID-19, rather than as a way to prevent contracting it.
Scant guidelines on how to prioritize the drug's use have also left hospitals and medical centers coming up with their own parameters for who to reserve the drug for. For example, some hospitals and medical centers are reserving the drug for the highest-risk patients, such as transplant recipients and cancer patients, while others are administering doses on a lottery or first-come, first-served basis.
"The biggest problem is that there is absolutely no guidance or prioritization or any rollout in place at all, and it's been a mess," said Dorry Segev, MD, PhD, a transplant surgeon at Johns Hopkins Medicine in Baltimore. "Without formal guidelines, you can't really do anything," he told the Times.
Additionally, there's no easy way for patients to find places that have received and are administering Evusheld.
All of this complicates access for immunocompromised patients who may not mount a strong immune response to vaccination or who cannot be vaccinated for medical reasons. The Times spoke to a number of patients seeking the treatment who were either denied by hospitals, spent hours trying to locate places that had it, or drove hours to get it.
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