As U.S. officials look to ramp up COVID-19 vaccinations heading into March, they’re not overlooking another pandemic-fighting tool. Eli Lilly on Friday scored a government supply deal for its newly authorized antibody cocktail, which dramatically reduced deaths and hospitalizations in a late-stage trial.
Lilly agreed to sell the U.S. government 100,000 doses of the bamlanivimab-etesevimab combination for $210 million. The doses will be delivered before the end of March, and the government has the option to purchase 1.1 million more doses through Nov. 25 depending on demand.
The deal adds to other large antibody supply agreements inked by the federal government and pharma companies. Eli Lilly has already supplied the government with 1 million doses of bamlanivimab alone, and it agreed to supply another 450,000 doses of that drug by the end of March.
For Lilly's combo, a trial in more than 1,000 high-risk patients showed a dramatic reduction in hospitalization and death risks compared with placebo. For those who received the drug combination, 11 were hospitalized and none died in the study. That compared with 36 hospitalizations and 10 deaths among placebo patients, or a 70% risk reduction.
Investigators conducted that trial at 2800 mg doses for each drug, but separate phase 2 data showed similar effects from the FDA-authorized doses—700 mg for bamlanivimab and 1400 mg for etesevimab. The lower doses will help stretch supply to aid the rollout.
Lilly has partnered with Amgen to scale up its cocktail supply this year.
Regeneron, the other leading antibody player, struck a massive supply deal worth $2.625 billion for 1.25 million doses of its antibody combination called Regen-Cov.
In the fourth quarter of last year, those deals delivered hefty revenues to the drugmakers. Eli Lilly’s bamlanivimab pulled in $871 million, thanks to its first U.S. supply deal, compared with $146 million for Regeneron’s combo treatment. Lilly expects $1 billion to $2 billion in 2021 revenues for COVID-19 therapies.
The U.S. government is buying the doses to provide them to patients at no charge out of pocket, although Lilly notes that healthcare facilities may charge to administer the drugs.
COVID-19 antibodies, hailed by experts such as former FDA Commissioner Scott Gottlieb, M.D., as a vital tool in fighting the pandemic, have been somewhat overlooked in recent weeks as the vaccination drive has ramped up. Uptake hasn't been as strong as expected, but data supporting their use show a potential to improve outcomes for high-risk patients who do contract the virus.
The antibodies are authorized in patients with mild to moderate cases of COVID-19 who are at a risk of going on to develop severe disease. Because many of those patients aren't already in a healthcare setting where the drugs can be infused, initial use has lagged expectations.
At the time of Lilly's combo authorization, the FDA signed off on 21-minute and 16-minute infusions for the combo and bamlanivimab alone, respectively. Previously, bamlanivimab infusions took an hour. The FDA shortened the infusion time to reduce burdens on healthcare systems after hearing from front-line doctors and nurses.