COVID-19 Therapeutics Allocation & Requests

Oregon Department of Human Services sent this bulletin at 01/23/2023 04:13 PM PST

Therapeutics Allocation & Requests

Thank you for your role in supporting access to therapeutics in Oregon. The Oregon Health Authority (OHA) appreciates your partnership as we continue navigating the federal allocation process.

Federal Allocations

Week of January 23rd:

mAbs Allocation Cycle

Evusheld (monthly): 2,340

Oral antivirals - Weekly (one week cycle)

Lagevrio (molnupiravir): 211
Paxlovid: 1,180
Renal Paxlovid: 105

Important Updates

New: NIH Guidelines Panel Updates

January, 2023 - Statement regarding Evusheld

The COVID-19 Treatment Guidelines Panel’s Statement on Tixagevimab Plus Cilgavimab (Evusheld) as Pre-Exposure Prophylaxis of COVID-19

In the US, the prevalence of subvariants likely resistant to tixagevimab plus cilgavimab (Evusheld) is more than 91% (now ~94%). Therefore, although tixagevimab plus cilgavimab is still authorized by the FDA for COVID-19 pre-exposure prophylaxis (PrEP), it is unlikely to be effective at preventing COVID-19 in most individuals. However, no alternative options for PrEP are available, and clinicians could still administer tixagevimab plus cilgavimab after considering an individual patient’s risks and the regional prevalence of the resistant subvariants (HHS, 2023).

Therapeutics Activity Against Emerging Variants

Paxlovid/Lagevrio/Veklury are expected to retain activity against all circulating variants based on preliminary data and sequence analysis, additional data is pending.
mAbs currently not authorized for use (Regen-COV, bam/ete, sotrovimab, bebtelovimab) are routinely tested against emerging variants.

Please review the COVID-19 Outpatient Therapeutics Clinical Decision Aid for Ages 12+ years and Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Professionals
Federal Test to Treat Digital Toolkit
The Oregon Health Authority has partnered with Color Health to offer free telehealth visits in Oregon. To learn more, please visit our COVID-19 Treatments page.
 Our December COVID-19 Therapeutics Newsletter is now available for therapeutics updates, events, community engagements and more!

Evusheld

Evusheld EUA fact sheet
Evusheld shelf-life extensions
Evusheld re-dosing
The AstraZeneca Call Center remains available should you have questions regarding the updated dosing guidance and/or the shelf-life extension for Evusheld. The AstraZeneca Call Center can be reached at 1-800-236-9933. Evusheld can also be directly ordered in small quantities for individual providers through this form: OrderEvusheld.com

Paxlovid

Paxlovid EUA fact sheet
Paxlovid shelf-life extensions
This information sheet summarizes current information about Paxlovid and offers resources about other COVID-19 therapeutics
Please view the new Paxlovid Patient Eligibility Screening Checklist Tool for Prescribers that is intended as an aid to support clinical decision making for prescribers
If you requested Renal Paxlovid, but did not receive it, you might be allocated supplemental Paxlovid. Please review the guidance on renal dosing for Paxlovid

Paxlovid Renal Adjustment
Providers should report utilization of the renal dose as "Renal Paxlovid" in HPOP

Please review the Paxlovid Rebound document

Lagevrio

NEW! COVID-19 Convalescent Plasma (CCP)

NIH Guidelines Panel Update

Veklury® (Commercial Product)

FDA approved expanded use of Veklury(remdesivir) to certain non-hospitalized adults and pediatric patients for treatment of mild-to-moderate COVID-19 disease (Jan 21, 2022)
Veklury Product Information
Veklury Fact Sheet
To purchase Veklury, please visit: Gilead Pharmaceuticals
Veklury is available through multiple distributors. For additional information regarding purchasing or how to access Veklury (remdesivir), email remdesivir@amerisourcebergen.com, or reach out directly to your AmerisourceBergen, Cardinal, or McKesson representative

Additional Resources

If you are needing additional assistance with provider registration, ordering, or any other process related to therapeutics, please fill out the Office Hours Request Form to select office hour availability
The federal government has released the Test to Treat Locator to make it easier to find Test to Treat (T2T) sites and where to send prescriptions to be filled

Please check the locator periodically as sites continue to be added
The locator's accuracy relies on providers reporting inventory and utilization
For additional clinical guidance, please review the University of Liverpool COVID-19 Drug Interaction tool

For additional guidance on the new ordering process, cadence, and reporting utilization, please review our Provider Operations Manual
For additional federal updates, shelf-life extensions, and more, please visit the ASPR webpage

Placing Requests

All orders are to be placed via the Health Partner Ordering Portal (HPOP).
If you are a new provider site and have not signed up to receive therapeutics via Oregon Health Authority, please complete the Complete the COVID-19 Therapeutics Provider Registration Survey.

Product Case Size

Each product has a specific case size and is outlined below. When ordering, please consider the case size and order accordingly to ensure OHA can fulfill your requests properly.

Evusheld - 12 courses
Paxlovid - 20 courses
Renal Paxlovid - 5 courses
Lagevrio (molnupiravir) - 15 courses

Webpages

For information on mAbs, please visit: OHA's Monoclonal Antibody Webpage

For information on oral antivirals, please visit:  OHA's Antiviral Webpage

Cadence

Monday - HHS notifies Oregon of our total therapeutics allotment.

NOTE: HHS informs Oregon of Evusheld’s total allotment monthly, every 4th Monday

Wednesday - Orders received by 11:59 p.m. will be allocated for the current week
Thursday/Friday - OHA staff will review the requests, determine allotments for each requesting site, and process via the Health Partner Ordering Portal (HPOP) by Friday.

NOTE: AmerisourceBergen anticipates shipping the products within 3-5 days of order submission.

Utilization reporting

It is crucial that each site report their utilization twice a week on Mondays and Thursdays by 11:59pm, including for any product redistributed to other sites. Under-utilization in HPoP and under-reporting will affect Oregon’s future allocations.

Track your shipment

Once your packages are shipped by Amerisource Bergen, you can track them using Track My Shipment Tool. 

For oral antivirals shipment tracking, please visit your HPOP account and reference "Therapeutic Shipping."

Thank you,

COVID-19 Therapeutics

Oregon Immunization Program

OREGON PUBLIC HEALTH DIVISION

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