Evusheld: Is it worth having now in Australia?

[Biker7]

Finally Evusheld is available. But is it of any use now considering the new variants?

[CLLerinOz Administrator]

Hi Biker7

Mike Honey from a data solutions company puts out regular alerts about the dominant variants in each state in Australia and how they're tracking. His latest update details the main variants circulating here at present and indicates that XBB 1.5 is now on an upward trajectory. Evusheld is considered to be inactive against it. I've not checked how it fares against the others but suspect they're now much of a muchness in that regard, too.

twitter.com/Mike_Honey_/sta...

Late last year, I was told I would receive my second course of Evusheld in early Feb 2023. However, when that time came around last week, I discovered that my hospital no longer has any stock and doesn't anticipate getting any in the near future.

This statement on the Victorian Health Dept website, which was last reviewed two days before Christmas 2022, explains how that might have come about:

"Tixagevimab and cilgavimab (EvusheldTM) continues to be available in Victoria for use in high-risk people for pre-exposure prophylaxis (PrEP) of COVID-19, with all stock from the National Medical Stockpile (NMS) expiring on 31 December 2022. It is highly unlikely that further stock will be available from the NMS in 2023. Therefore, from January 2023 access will be up to individual hospitals to consider making available with a projected cost per dose of >$2500. (my emphasis)

The Therapeutic Goods Association (TGA) announced revised dosing recommendations for the use of EvusheldTM, increasing the standard dose from 300mg to 600mg. Top-up doses for already treated patients is at clinician discretion. Sites can administer double dose for PrEP, however there is no guarantee that NMS stock used will be replaced as there is limited NMS stock available in Victoria."

health.vic.gov.au/covid-19/...

I imagine that hospitals around the country are, therefore, in the same situation as those in Victoria. Perhaps someone in another state can provide an update about their situation.

I contacted my local pharmacy that's listed as an Evusheld provider. They don't have any either but they said that they could try to source some if I were prepared to pay for it privately and could get authorisation. I decided to pass.

Just over two weeks after the TGA announced its provisional approval of the increased dose of Evusheld here in Australia, the US temporarily withdrew its authorisation, stating that Evusheld was no longer active against the variants responsible for more than 90% of cases there and today NICE announced that it has decided it won't be offering it on the NHS because "Evusheld is unlikely to prevent infection with most of the variants circulating in the UK now and in the near future".

healthunlocked.com/cllsuppo...

nice.org.uk/news/article/ni...

Let's hope that 'Evusheld 2.0' which is in development comes through its trial period with flying colours and that it and other prophylactic treatments might become available before year's end.

CLLerinOz

[Biker7 in reply to CLLerinOz]

Thanks CLLerinOz for your very helpful information.