April 06, 2021
3 min read
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Clinicians developed a model for the distribution of COVID-19 neutralizing monoclonal antibody treatments that they said could be useful for other major health systems.
In an article published on the Open Forum Infectious Diseases, they examined the assignment and administration of antibody treatments in 35 hospitals and several senior facilities, qualified care facilities, and outpatient providers in the University of Pittsburgh Medical Center (UPMC) health care system.
“In addition to preventive measures such as masks, social distancing and vaccination, as well as the various therapies for the inpatient treatment of COVID-19 patients, passive antibody therapy with monoclonal antibodies offers an option for treating mild to moderate outpatients who can prevent progress towards hospitalization “ Ryan Bariola, MD FIDSA, a clinical associate professor of medicine in UPMC’s Infectious Diseases Department, and colleagues wrote.
“We are awaiting further clinical evidence of the benefits of these compounds for patients. In the meantime, we are sharing our efforts and learning to help everyone do this in a fair and effective way, realizing that this may be a model for distributing other grooming products. “
Healio spoke to Bariola about the distribution model and how it can be applied in other environments.
Healio: What strengths of the distribution network does this article highlight?
Bariola: I think a great strength is that we have worked very hard to develop the infusion center’s capacity for these treatments in every area of Pennsylvania in which we operate. Expecting patients with COVID-19 to travel to a central urban location would have restricted access for many of our patients. The vast majority of our patients are currently in one or two districts of an infusion center. We have also worked with home health services to provide this treatment to patients in their home country who have no transportation or are too frail to travel to an IV center. Finally, we have tried to make the system easier for patients. We proactively call all eligible patients with positive tests in our healthcare system to discuss this option with them, and we have a 1-800 number so patients outside of our system or without a provider to order can call for help .
Healio: Can this network be replicated in other areas?
Bariola: I think so. For multi-site healthcare systems, they should strive to decentralize infusions as much as possible and only think outside of their largest center. We identified locations for new stand-up infusion centers when we didn’t have one in a region in which we operate. Infection prevention concerns can be addressed by devoting certain areas of an infusion center to COVID-19 patients or specific hours of the day only to patients with COVID-19. It is also important to make the process easily accessible to patients. Develop an easy-to-navigate process for individual hospitals so that your regional providers and patients can access your system.
The FDA only allows these treatments to be used within 10 days of symptoms appearing, and we think the earlier is better. Limiting time delays is critical. At the same time, we need to ensure that all patients are eligible under the FDA’s emergency clearance, so a quick review process needs to be included. Finally, it is important to let providers and patients know that these treatments are available.
Healio: What specific considerations – geographic, demographic, etc. – need to be made when building a distribution network like this?
Bariola: Think about where your patients live, where your infusion centers are, and where your COVID-19 hotspots are. Make sure that all areas are covered equally with access to an infusion site. Think about the socio-economic factors of the areas in which you operate and remove any barriers to care that may exist in some of these areas. Make sure all the communities you serve are informed about these treatments.
Healio: How have health system administrators adjusted the ever-evolving data and studies on COVID-19 monoclonal antibody treatments?
Bariola: At UPMC we have a group of clinical experts who evaluate all possible treatments for COVID-19 and make system-wide decisions about what should and should not be used. This group will keep abreast of the current medical literature and monitor suitability decisions for these and other treatments. Additionally, we must follow FDA guidelines on how these treatments can be used.
Healio: What improvements can still be made to this distribution network?
Bariola: The biggest area we are working on to improve is awareness from both providers and patients. These treatments can be difficult to draw attention to. The clinical benefits of these treatments are increasing, but some providers are still hesitant given concerns about effectiveness. And with the very proper attention given to vaccination, many citizens are unaware of this option when they become infected.
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