Is Antibody Cocktail Offering The Right Mix?
Bio Spectrum|August 2021
Although the clinical outcomes, as well as clinical trials, have been very promising for patients treated with the antibody cocktail so far, the Delta plus variant is considered to be resistant to the monoclonal antibody (mAb) cocktail treatment.
Prabhat Prakash

India continues to roll out vaccines for the prevention of COVID-19. While the vaccination drive continues, India has been considering alternative therapies for the treatment of COVID-19. On May 5, 2021, the Central Drugs Standards Control Organisation (CDSCO) provided emergency use authorization for the antibody cocktail (casirivimab and imdevimab) in India. Former US President, Donald Trump was administered the experimental Regeneron antibody treatment in October 2020, when he tested positive for COVID-19.

The antibody cocktail has been developed by US biotechnology company Regeneron, in association with Roche Pharma. The antibodies bind themselves to two different sites on the SARS-CoV-2 spike protein, neutralizing the ability of the virus to infect human cells.

Cipla is marketing the drug manufactured by Roche Pharma in India. The drug is accessible through hospitals and COVID-19 treatment centers. It can in total potentially benefit 200,000 patients as each of the 100,000 packs that will be available in India offers treatment for two patients. Cipla is distributing the product by leveraging its strong distribution strengths across the country. The drug will be available through leading hospitals and COVID-19 treatment centres.

The cocktail is to be administered for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age or older, weighing at least 40 kg) who are confirmed to be infected with SARS-COV-2 and who are at high risk of developing severe COVID-19 disease and do not require oxygen.

The pharma majors (Cipla, Roche) claim that it has can help these high-risk patients before their condition worsens, reducing the risk of hospitalization and fatality by 70 per cent and shortening the duration of symptoms by four days.

Each pack of antibody cocktail contains one vial of casirivimab and one vial of imdevimab totaling 2400 mg of the antibody cocktail (one vial of casirivimab (1200 mg) and one vial of imdevimab (1200 mg). Each pack can treat two patients as the dosage per patient is a combined dose of 1200 mg (600 mg of basiliximab and 600 mg of imdevimab) administered by intravenous infusion or subcutaneous route. The vials need to be stored at 2°C to 8°C.

If opened for the first patient’ dose, a vial can be used for the second patients’ dose within 48 hours if stored at 2°C to 8°C. The price for each patient dose [a combined dose of 1200 mg (600 mg of casirivimab and 600 mg of imdevimab)] will be Rs 59,750 inclusive of all taxes. The maximum retail price for the multi-dose pack is Rs 119,500 inclusive of all taxes.

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