Understanding COVID-19 Therapeutics

What are COVID-19 Therapeutics?

COVID-19 therapeutics refer to medical countermeasures used to treat individuals who are already diagnosed with COVID-19. There are three major types of COVID-19 therapeutics that are currently available for patients who have been diagnosed with COVID-19: 

Learn more about the different types of treatments available for patients with COVID-19. If you are a healthcare provider and want additional information on reimbursement and NIH guidelines, go to the Provider Section at the bottom of this page. 


Monoclonal Antibodies (mAbs)

Treatment for non-hospitalized COVID-19 positive patients include the use of combination mAbs therapies where two or more drugs work together to fight COVID-19 variants:

  • Bamlanivimab & Etesevimab*
  • Casirivimab & Imdevimab

Treatment for Non-Hospitalized COVID-19 Positive Patients

TypeMonoclonal Antibody Treatment
TreatmentBamlanivimab & Etesevimab*1
(Eli Lilly)
Casirivimab & Imdevimab2
(Regeneron)
Eligibility• 12 y/o and up
• High-risk of developing moderate to severe symptoms including high fever, severe cough and shortness of breath
• Risk: Age, comorbidities
• 12 y/o and up
• High-risk of developing moderate to severe symptoms including high fever, severe cough and shortness of breath
• Risk: Age, comorbidities
AdministeredInfusionInfusion

*On April 16, 2021, the FDA revoked the emergency use authorization (EUA) for bamlanivimab monotherapy. The current EUA for combination therapy with bamlanivimab with etesevimab remains active.

As of 5/7/2021, the FDA recommends bamlanivimab and etesevimab should not be used by healthcare providers in the State of Illinois due to higher circulation of the P1 variant (identified in Brazil) in this state. Other states are not impacted by this announcement.

On May 6, 2021 CMS changed the rate for the administration of mAbs. Medicare will pay approximately $450 in most settings, or approximately $750 in the beneficiary’s home or residence.


What Is A Monoclonal Antibody (mAb) Therapeutic?

While antibodies are naturally created in our bodies, lab-created mAbs differ in that they are designed to attack a specific disease target, such as a virus, and are directly administered to a patient via infusion.

Find the closest monoclonal antibody therapy location using the National Infusion Center Association’s Infusion Center Locator

Learn more about mAbs from the COVID-19 Real-Time Learning Network, a collaboration between the CDC and Infectious Diseases Society of America. Additional resources are below.  

  • In the article titled, “Enlisting Monoclonal Antibodies in the Fight Against COVID-19” from the NIH Director’s Blog, Dr. Francis Collins explains how mAbs help fortify our immune response to the SARS-CoV-2 virus. 
  • The Biotechnology Innovation Organization (BIO) has produced an episode on their I am BIO podcast on the Eli Lilly mAb therapeutic, detailing how clinical data from trials have shown reduced hospitalization in patients for COVID-19 when taken during the early stages of infection. 
  • Harvard Medical School has developed an in-depth look at the current therapeutics currently available for patients with COVID-19. They provide an accessible summary of mAbs and their use against this disease.
  • HHS’s Office of the Assistant Secretary for Preparedness and Response has a dedicated website for all mAbs that includes fact sheets, FAQs, and more. 
Eli Lilly Monoclonal Antibody—Bamlanivimab and Etesevimab
  • Bamlanivimab and Etesevimab are investigational medicines that were given Emergency Use Authorization (EUA) from the FDA on February 25, 2021 and are being used to treat mild to moderate symptoms of COVID-19. These two medicines are administered to the patient through one intravenous infusion. For more patient information on this treatment, please see the EUA factsheet from Eli Lilly (Spanish).
  • You must be referred by a provider to receive this treatment. 
  • You can find more information on this treatment in this statement made by the NIH.
  • Visit this helpful guide for information on potential treatment costs, here: HHS CARES Act Provider Relief Funds for Patients
Regeneron Monoclonal Antibody Cocktail—Casirivimab and Imdevimab
  • Casirivimab and Imdevimab are investigational medicines that were given EUA from the FDA on November 21, 2020 and are being used to treat mild to moderate symptoms of COVID-19. These two medicines are administered to the patient through one intravenous infusion. For more patient information please see the EUA fact sheet from Regeneron (Spanish).
  • You must be referred by a provider to receive this treatment.
  • You can find more information on this treatment in this statement made by the NIH.
  • Visit this helpful guide for information on potential treatment costs, here: HHS CARES Act Provider Relief Funds for Patients

For more information on the FDA’s EUAs for current COVID-19 mAb therapeutics – Bamlanivimab and Etesevimab, and Casirivimab and Imdevimab – visit the FDA website on EUAs.

For more information on how mAbs work against COVID-19, patient eligibility criteria, and what you can expect when receiving this treatment, visit this HHS overview: www.combatcovid.hhs.gov.


Antiviral and Convalescent Plasma

Treatment for hospitalized COVID-19 positive patients include:

  • Remdesivir
  • Convalescent plasma

What Is an Antiviral Therapeutic?

An antiviral therapeutic works to inhibit the replication of viruses in our bodies by stopping messenger RNA from relaying instructions to keep producing the genetic material needed for a virus to survive.

Gilead Antiviral Therapeutic—Remdesivir
  • Remdesivir is an antiviral drug that was approved by the FDA on October 22, 2020 for the treatment of COVID-19 requiring hospitalization on and is used to treat severe symptoms onset by COVID-19. This treatment is only available to be administered in a hospital setting through an intravenous infusion. More patient information can be found in the Gilead factsheet.
  • The New England Journal of Medicine published a final report on the effect of remdesivir on hospitalized patients with severe symptoms from COVID-19. Their final conclusions show evidence for clinical improvement and reduced mortality for patients treated with remdesivir versus those who received the placebo. 
  • If you still have questions on information not covered here, the FDA has a FAQ for remdesivir, that can be found here.
  • Visit this helpful guide for information on potential treatment costs, here: HHS CARES Act Provider Relief Funds for Patients

What is Convalescent Plasma? 

COVID-19 convalescent plasma is human plasma collected from individuals whose plasma contains anti-SARS-CoV-2 antibodies and meets donor eligibility requirements. Patients with COVID-19 may improve faster if they receive plasma from those who have recovered from COVID-19 early in the course of disease, because it may have the ability to fight the virus that causes COVID-19.

  • On August 23, 2020, the FDA issued an EUA for COVID-19 convalescent plasma for the treatment of hospitalized patients with COVID-19. This treatment is only available to be administered in a hospital setting or clinical trial.
  • For information on clinical trials that are testing the use of COVID-19 convalescent plasma for COVID-19, please see www.clinicaltrials.gov.
  • The New England Journal of Medicine published an article on the impact on convalescent plasma antibody levels has on the risk of mortality. Their conclusion shows a reduced mortality in patients with higher antibody levels when compared to patients with lower antibody levels.
  • You can find more information on this treatment on the FDA fact sheet.

Provider Resources For COVID-19 Therapeutics by Therapeutic Type

To keep up to date with the latest information on patient eligibility and treatment guidelines, visit the NIH’s guide for COVID-19 Treatment Guidelines

Other resources that may be helpful include: 

Regeneron Monoclonal Antibody Combo Therapy —Casirivimab and Imdevimab
  • If you are a healthcare provider and would like more information on the administration of this drug, please visit the Regeneron website for healthcare providers.
Eli Lilly Monoclonal Antibody Combo Therapy—Bamlanivimab and Etesevimab
 Gilead Antiviral Therapy—Remdesivir
  • If you are a healthcare provider and would like more information on the prescription and administration of this drug, please visit Gilead’s resource center for healthcare providers.
Convalescent Plasma 
  • If you are a healthcare provider and would like more information on the administration of this drug, please visit the FDA’s factsheet for healthcare providers.