The majority of monoclonal antibody treatments for COVID-19 have been administered in assisted living communities, a new analysis finds.

Using Medicare data, consulting firm Avalere examined a sample of 737 COVID-19 monoclonal antibody claims. Fully 67% were administered in the assisted living setting.

The infused treatments have been heralded by some geriatricians and industry advocates as a boon for long-term care — especially after Eli Lilly reported success in an unusual clinical trial conducted in nursing homes. The therapy has many strong points in its favor: clinical utility, approval for emergency use by the Food and Drug Administration, and no out-of-pocket cost-sharing for patients. Yet the researchers found that data was limited to 18 states, suggesting that despite its promise, use of the treatment may be lagging well below expectations in many states. 

The Department of Health and Human Services allocates the drugs weekly based on each state’s share of confirmed COVID-19 cases, as well as the total number of hospitalized patients over a seven-day period. But more than half of its stockpile remained unused in January, according to Medscape.

The slow uptake may be partly due to a normal lag between research findings and provider adoption, and clinicians may need to work a bit harder to encourage use, the authors said.

“It may be critical to draw provider attention to data supporting monoclonal antibodies as effective therapies,” they proposed. “Providers must be educated on the potential benefits. … In conjunction with vaccine education, these efforts may address hesitancy and increase patient confidence.”

To help providers, the U.S. Department of Health and Human Services created the SPEED (Special Projects for Equitable and Efficient Distribution) pilot program to provide mAbs directly to pharmacies serving long-term care communities.

Senior living association Argentum also is supporting the proposed Long-Term Care Infusion Nurse Corps, or LINC, through which volunteer Medical Reserve Corps nurses would administer mAb treatments in long-term care. The proposal still is under review by the Centers for Medicare & Medicaid Services but would provide additional, qualified personnel to help assisted living communities and other providers to provide the infusions.