Eli Lilly’s COVID-19 mAb bamlanivimab potential cost effectiveness underscores payer support

Eli Lilly’s monoclonal antibody (mAb) bamlanivimab is unlikely to face payer pushback, despite its broad label, after recent FDA emergency use authorization (EUA) experts told Manasi Vaidya, Pharma Writer for the Investigative News team at GlobalData, a leading data and analytics company.

Despite increased scrutiny on drug prices in the COVID-19 era, given the potential therapeutic and societal impact in stemming hospitalizations, bamlanivimab and other mAbs under FDA review could be considered cost effective.

Eli Lilly’s bamlanivimab received an emergency use authorization (EUA) to treat mild-to-moderate COVID-19 patients who are at high risk for progressing to severe COVID-19 and/or hospitalization. Lilly will be supplying 300,000 vials of 700mg bamlanivimab at a cost of $1,250 per vial.

Vaidya says: “Distribution channels are now different from nonpandemic times and uncertainty on demand coupled with specialized manufacturing requirements for mAbs could create their own barriers to access.

“Unlike situations where payers may require additional documentation or restrict use to a narrower patient population for a newly approved biologic, with COVID-19 a physician determination for bamlanivimab’s need may be adequate for coverage.

“This is especially so given the relatively modest price for the potential to reduce the burden on crowded hospitals. If bamlanivimab and other similar monoclonal antibodies can reduce hospitalization risk, they could be prevent anxiety and loss of income that would have resulted otherwise, and thus be cost effective.”

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