CVS prepares to administer Lilly antibody drug, as feds buy 650,000 more doses for $812.5M

CVS Health Corp. will administer Eli Lilly and Co.’s COVID-19 treatment in patients’ homes and in long-term care facilities through a program with the U.S. government’s Operation Warp Speed, the pharmacy chain said.

The announcement came just hours before Lilly said that the federal government has purchased 650,000 additional doses monoclonal antibody therapy, bamlanivimab, which has been found to keep patients in the early stages of COVID-19 from developing more severe disease that requires hospitalization.

The government will pay $812.5 million for the drugs, which will be delivered through Jan. 31, with at least 350,000 of the additional doses delivered this month. The latest agreement brings the total doses purchased by the U.S. government to 950,000.

The drug itself will be free to patients. However, health care facilities will be allowed to charge a fee for administering it. CVS, however, said it won’t charge patients.

The treatment requires patients to receive an hour-long infusion, usually at a medical facility, where they could put others at risk of contracting the disease.

Moving that process into the home could help reach more people, especially those who are highly vulnerable and less mobile, such as nursing-home residents. It could also ease the strain on resource-strapped hospitals. Coronavirus cases are rapidly rising across the U.S. and nursing homes are being hit especially hard.

CVS’s Coram infusion business will receive 1,000 doses of the therapy in the program’s initial phase, which is scheduled to start on Thursday in seven markets: Boston, Chicago, Cleveland, Los Angeles, Milwaukee, Minneapolis and Tampa, Florida. Hospitals, primary-care doctors, urgent-care centers and long-term care facilities can refer patients to receive a home infusion. The effort could be expanded in coming months, said Sreekanth Chaguturu, chief medical officer of CVS pharmacy-benefits manager Caremark.

“We are excited to be a solution working closely with provider networks to allow for referrals of covid-19 patients for the monoclonal antibody so that we can support the health-care system,” said Chaguturu, the clinical lead on the program, in an interview.

Coram won’t charge patients or insurers for the service, Chaguturu said. The U.S. government awarded CVS a $494,000 contract to run a program administering the drug.

On Nov. 11, the Food and Drug Administration cleared Lilly’s treatment for emergency use in high-risk patients within their first 10 days of symptoms. A similar drug from Regeneron Pharmaceuticals Inc. also gained emergency clearance last month. The therapies, while lauded for their efficacy, are difficult to manufacture and in short supply.

Administering the therapies has been challenging for health care facilities, as many infusion centers are used to treating people with fragile immune systems, such as cancer patients. Some hospitals have set up separate sites to infuse COVID patients. At the same time, some patients are unable to get to the facilities on their own.

“We are grappling with the issues of the logistics of delivery, and what amount of doses we might have,” said Rajesh Gandhi, an infectious diseases physician at Massachusetts General Hospital and Harvard Medical School. “We need to do this in a place where it can be administered safely.”

Coram will provide in-home treatment in areas the Department of Health and Human Services designates as high in need. To identify candidates for the therapy, Coram will take referrals from local doctors. Coram will send nurses to collect information, administer the infusion and observe patients for side effects, a process Chaguturu says takes about three hours.

Chaguturu expects the first 1,000 doses to be used quickly. Once that supply runs out, CVS hopes it can offer another 1,000 doses.

“Our hope is that this is a pilot that will convert into a longstanding operating model beyond the 1,000,” Chaguturu said. “We’re hopeful that we’re not in a position where we would have to say no to individual.”

Initially, the program will only administer Lilly’s therapy. CVS said it is ready to provide other COVID infusions as it expands the program and supplies increase over the coming year.