No clear US plan on how COVID-19 antibody drugs will be distributed, paid for if approved

Both Regeneron and Eli Lilly have submitted emergency use authorization requests with the FDA for their COVID-19 antibody drugs, but there is no clear system for how the federal government will make sure the drugs will be allocated fairly or how they will be paid for if they are approved, NPR reported.  

Eli Lilly has said it will produce more than 1 million doses of its antibody drug before the end of the year. Regeneron has signed a $450 million deal with the U.S. government to supply 300,00 doses of its drug. But with 50,000 Americans testing positive for COVID-19 daily, demand will far outstrip supply, Rena Conti, PhD, an associate professor of markets, public policy and law at Boston University, told NPR.  

The drug may be free at first, as the government has subsidized development and production of Regeneron's antibody drug and promised to purchase the first batch. But both drugs have to be given by IV infusion, which is expensive and must be done in a hospital or specialized infusion center. 

Even Medicare beneficiaries have copays for many infused drugs, NPR reported, and copays are typically 20 percent of the price of a drug. The antibody drugs' copays could be hundreds of dollars. Dr. Conti predicts the price of the drugs to be $2,000 to $10,000 per treatment. If insurance companies pick up the costs of the drugs, they would ultimately be passed along in premiums. 

As for allocation, Jewel Mullen, MD, the associate dean for health equity at the University of Texas' Dell Medical School, told NPR the drugs should be given to healthcare workers and first responders first, then to vulnerable populations who stand to benefit most. 

Distribution of the drugs will be costly. Dr. Conti said the drugs must be shipped in temperature-controlled trucks and have to get to rural areas facing COVID-19 outbreaks. 

Becker's has reached out to HHS for comment and will update this story accordingly. 

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