DAVID GREENE, HOST:
The Food and Drug Administration has given its thumbs up to a drug that's designed to prevent people with mild to moderate COVID-19 from getting sicker. This drug will be available to people over 65 or with underlying health conditions. The FDA has not fully approved it, but it has authorized it for emergency use. NPR science correspondent Richard Harris is here to talk about this. Good morning.
RICHARD HARRIS, BYLINE: Good morning, David.
GREENE: So tell me more about this drug.
HARRIS: Well, it's called a monoclonal antibody. And this one is made by Eli Lilly. President Trump got a similar medication from a company called Regeneron, but that product is still under review at the FDA. Now, these are synthetic antibodies that block the virus and prevent it from infecting cells. And the idea is to give people who have mild to moderate illness but aren't sick enough to be in the hospital, keep them out of the hospital, and that's really the goal of this drug.
GREENE: And does it seem to work pretty reliably?
HARRIS: Well, here's the thing - most people with mild to moderate COVID never end up in the hospital, so most people won't actually benefit from this in an obvious way. The FDA wants to restrict it to people who have a higher risk, like a 10% chance of needing hospitalization. And in that population, they figure the hospitalization rate would drop to about 3%. So looked at another way, if you give this to 100 people, it could theoretically prevent seven hospitalizations. So, basically, improves the odds a bit.
GREENE: But if you think you might be eligible, I mean, is this something you would get from your doctor? Or how would you get access to it?
HARRIS: That's one of the big challenges of this drug because it needs to be given by IV infusion, and that isn't simple. Dr. Walid Gellad at the University of Pittsburgh predicts that it's going to be chaotic figuring out how to administer the drug.
WALID GELLAD: We don't want people running to the emergency room to get this therapy. We don't want people running to infusion centers, where there are patients with cancer. And we don't want them running necessarily to their primary care doctor's office that are not set up for these infusions. It is not clear at all where the infusions are going to happen.
HARRIS: Maybe hospitals will set up tents. But in any event, he says it raises all sorts of questions about fair and equitable access to this drug.
GREENE: I mean, at a moment when we're seeing, you know, record-high new cases in this country, which begs the question - I mean, could we reach a point where there's just not enough of this drug to go around?
HARRIS: Well, there clearly won't be enough, at least not in the short run. Eli Lilly says it hopes to have a million doses by the end of the year, which sounds impressive, but considering that every day there are tens of thousands of new coronavirus cases in the United States, even that big-sounding supply really won't stretch. So that could be one reason the FDA has decided to limit its use to people at highest risk - those people over 65 and with underlying health conditions, including obesity.
The federal government has agreed to purchase 300,000 doses and distribute them to the states. And the drug costs more than $1,200 per dose, so it's a relief that the government has at least picked up the tab, at least for that initial supply.
GREENE: So during his campaign, President Trump promised seniors that they would get access to these kinds of antibodies at little or no cost, just like he was able to. You mentioned that he got something like this. Will that be the case here?
HARRIS: Well, even though the drug itself will be free, the treatment won't be. I talked to health care economists, who figured out the cost to seniors could end up somewhere between $50 and $300 per treatment, depending upon the Medicare plan and whether a person has reached the annual deductible and so on. Medicare says hospitals can volunteer to waive their fees, but that's unlikely to happen. Commercial insurers, on the other hand, have been providing coronavirus treatments at no cost, so we'll see if that extends to the monoclonal antibodies. And the uninsured could face hefty bills here.
GREENE: So big picture, Richard, how does this fit into the larger sort of picture of coronavirus treatment?
HARRIS: Yeah, there is an antiviral drug called remdesivir, which is given to hospitalized patients, and studies shows that it shortens hospital stays, but it hasn't been proven to save lives. Another drug, dexamethasone, is a lifesaver and is used in patients who are seriously ill. The monoclonal antibodies fill a different niche, basically keeping people out of the hospital. Of course, you may recall that strategy didn't work for Trump...
HARRIS: ...Who ended up in the hospital anyway after his treatment with monoclonal antibodies.
GREENE: All right. NPR science correspondent Richard Harris. Richard, thanks as always.
HARRIS: Pleasure to be with you.
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