What is sotrovimab? Alberta Doctor Explains How Health Canada Approved New COVID-19 Drug Works

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This week, Chief Medical Officer for Health Dr. Deena Hinshaw announced that Alberta is launching sotrovimab, a new drug recently approved by Health Canada to treat COVID-19.

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Postmedia spoke with infectious disease physician Dr. Ilan Schwartz to learn about sotrovimab, how it works, and who is eligible to receive it.

This interview has been edited for clarity and length.

What is sotrovimab?

Sotrovimab is a monoclonal antibody, a laboratory-made version of a protein that your body would normally make to fight the virus. Antibodies are the artillery we use against foreign invaders like viruses and are trained by immunization or previous infection. People who have not been vaccinated or infected with COVID-19 do not have antibodies to the virus, therefore a role in increasing their own immune response by providing an exogenous source of these antibodies.

How is the medicine provided?

It is a one-time intravenous infusion that must be given within the first five days of the onset of symptoms. To date, there have been logistical challenges for patients infected with COVID-19 and at an early enough phase, which also corresponds to the period of greatest infectivity. The idea of ​​taking these patients to an intravenous infusion site, which is used primarily for people with cancer, has been very problematic.

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It has now been overtaken by Alberta Health Services by deploying Integrated Mobile Health Units (MIH), community paramedics who go to patients’ homes to provide treatment. It is an exciting and innovative use of these healthcare professionals. Nor is it a particularly efficient or scalable solution. Fortunately, the majority of the population has been vaccinated and only a small part will still benefit from this.

Who is eligible to receive sotrovimab?

People who are not vaccinated and are over the age of 65, as well as people who receive organ or bone marrow transplants, regardless of their age or vaccination status, are eligible at this time. Patients or their physicians are encouraged to self-refer or refer patients through Health Link.

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What do we know about its effectiveness?

Currently, twenty patients need to be treated with this therapy to avoid a patient going to the hospital. The drug is approximately 80% effective in preventing hospitalization. It’s pretty good, certainly much better than any other outpatient therapy that has been tested so far and approved by Health Canada.

Could this deter the unvaccinated from getting vaccinated?

Although the program is as efficient and effective as possible, it is not as efficient and responsive as the body’s own ability to produce antibodies after vaccination. Not everyone will qualify for this treatment. We are currently restricted to people residing near one of these MIH units, and not all areas, particularly rural areas, will have access. Some may go unnoticed, as many patients feel pretty good in the first five days and may not even contact their doctor for a diagnosis. This should not be considered a substitute for vaccination. At the end of the day, vaccination is the safest, most effective, and most cost-effective way to prevent serious illness.

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How expensive is sotrovimab?

It is purchased by Health Canada and I have not seen the contract, but the label value of this drug in the United States is $ 2,100 per dose. The cost of administering this treatment, which requires a team of paramedics to be at the patient’s home while administering an infusion for more than an hour and then for another hour thereafter to monitor for allergies, is substantial. It is certainly not a project that can be expanded. If we can keep people out of the hospital, then it’s probably cost-effective given that these hospital stays are, I think, on average, around $ 25,000 per admission, or $ 75,000 if you need to enter the ICU.

What’s it like to have a drug available to treat COVID-19?

It is bittersweet. It’s good that we now have something to offer patients. The irony is that we need it much less now than in previous phases of the pandemic, when fewer people were vaccinated. As not just an infectious disease doctor, but one who specializes in organ transplant patients, I am very happy that we have this and that we can offer it to those people who have been vaccinated, who have followed all public health restrictions. but who have still been infected and are at very high risk of requiring hospitalization or dying.

The flip side of things is that we now have something to offer unvaccinated people who, ironically, have rejected our very strong and heartfelt recommendations to get vaccinated in the first place. But it’s about reducing the harm at this point and if people choose not to get vaccinated and if we have a therapy that can prevent them from getting sick or dying, of course we are bound to use it.

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