Thread by @Jim__Jackson

I see that there is a lot of interest in monoclonal antibody infusions, so I will discuss our process for administering them. I think it is a great treatment with very little downside.

We are giving the infusions to patients diagnosed with COVID and to high risk patients with exposure (spouses mainly). Here is a fact sheet from the FDA discussing the treatment and the qualifications for receiving it. We generally follow these guidelines.
fda.gov/media/143894/d…

Since Medicare supposedly pays for these infusions, the out of pocket charge for Medicare patients is zero. Private insurers are not required to pay for monoclonal antibody treatment, and because it is still considered experimental, they almost certainly will not do so.

For privately insured or self pay patients, we charge a $350 deposit for IV or $250 for SQ route. This is mainly due to the cost of the tubing and filters as well as the cost of tying up one of our beds for 2 hours. Since we get the medication for free, we don't charge for that.

We do file the claims with insurers, and if they happen to pay then we will refund the deposit. In my experience health insurance companies will deny a claim every chance they get, and an experimental medication seems like an obvious denial. A few plans will probably pay though.

We give the IV medication via pump over 30 minutes. Regardless of the route of administration, we obseve each recipient for one hour after completion as recommended by the manufacturer.

Most patients have a completely uneventful infusion. I have not seen what I would characterize as an allergic reaction to any of our infusions, although that is supposedly why we need to observe them for so long.

Very rarely patients can get worse during or immediately after the infusion, so if they are already sick to start with, you should be careful. In my experience, patients who are older or tenuous with borderline saturations in low 90s are more likely to deteriorate afterwards.

I haven't had time to follow up all of our patients, but the ones I have followed up typically reported dramatic improvement as soon as the following day. The sooner they get the infusion after the onset of their symptoms, the more likely this seems to be the case.

I do think there is a role for this therapy toward the end of the 10 day symptom period for those who simply aren't getting better, it just seem that their improvement isn't as quick or dramatic. I enjoy giving it to both groups though.

I have not had a single patient tell me that they wished they hadn't gotten this treatment, while most are extremely grateful. I do plan to do more detailed followup when I get a break from the overwhelming number of patients we are seeing.

If you are looking for a place to get this therapy and can get to Houston, I will be happy to evaluate you to see if you are a candidate. We don't take appointments; we see everyone on a walk-in basis, and I personally work every Monday-Saturday.

Medicare will also pay for home administration of this medication, so if you live in the SE Houston area and are covered by Medicare, I might be able to provide it via housecall.