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What is Regeneron, the COVID-19 treatment Gov. Greg Abbott received? How much does it cost?

Nicole Villalpando
Austin American-Statesman

After Gov. Greg Abbott received a positive COVID-19 diagnosis on Tuesday, he received Regeneron, the company name for the FDA-authorized monoclonal antibodies. 

What is Regeneron?

Regeneron is actually the company that makes the the treatment Abbott received called REGEN-COV. It  is a mixture of two monoclonal antibodies: casirivimab and imdevimab. It is designed to block the spike protein in COVID-19 from attaching to and entering healthy cells.

It received FDA emergency use authorization in November for the treatment of COVID-19 symptoms in the early stages of the disease. In July, it received an expansion of the emergency use authorization. It has not yet received full authorization.

It is given intravenously at an infusion center, or it can be given as an injection in the upper arm, upper thigh or stomach.

REGEN-COV monoclonal antibodies treatment can be given to people who are at risk for severe disease or have early symptoms of COVID-19.

More: Texas Gov. Greg Abbott was vaccinated prior to asymptomatic COVID status

Who can receive REGEN-COV?

REGEN-COV is for someone in the early stages of a COVID-19 diagnosis, either with mild symptoms, or if you are 65 and older or are considered high risk, immediately following a diagnosis, even if you have no symptoms. It also can be given to someone who has a high risk for severe disease and has been exposed to COVID-19, but has not yet tested positive. You have to be at least 12 and weigh 88 pounds to receive Regeneron. It would be a decision between a doctor and a patient. 

Abbott, 63, has had a REGEN-COV treatment, but in his statement he did not explain why he received the treatment.

More: 14 children with disabilities sue Abbott to end ban on mask mandates in schools

High risk factors include being overweight or obese; chronic disease of the lungs, kidney, heart, liver; cancer; diabetes; a weakened immune system; pregnancy; dementia or other neurological conditions; smoking or a former smoker; blood disorders; having had a stroke; or having received a solid organ or blood stem cell transplant.

Who cannot receive REGEN-COV?

It is not for people who are already hospitalized because of COVID-19 or are on oxygen or are requiring more oxygen. 

Monoclonal antibodies can worsen the condition of a person on oxygen or on a ventilator. 

"This is an important treatment before you get to the hospital," said Dr. Nancy Foster, the president of the Travis County Medical Society, who works at Ascension Seton Medical Center. "It's something we should be taking advantage of."

More: Readers react to Texas school districts defying Gov. Abbott's ban on mask mandates

How do you get REGEN-COV?

Doctors recommend calling your primary care physician if you have been exposed to COVID-19 and are high risk or if you receive a positive test. 

Your doctor can determine whether you qualify and arrange for you to receive treatment, which requires a doctor's prescription and is given at an infusion center. 

It must be given before symptoms worsen to the point of a patient being hospitalized.

"If you show up to the ER short of breath, it's too late," said Dr. Scott Clitheroe, the president-elect of the Travis County Medical Society and an internal medicine doctor working most recently at Ascension Seton Medical Center. 

More: Defiance in Texas: Cities, counties, schools win latest round vs. Gov. Greg Abbott over mask mandates

What are the side effects?

You could have flulike symptoms, says Dr. Suneet Singh, the medical director of outpatient provider CareHive, including an increase in achiness or chills. You could also have a severe reaction such as anaphylaxis. Those side effects are still rare.

The reason to get it, though, is that it has been shown to prevent more severe COVID-19 symptoms and reduce hospitalizations by 70 percent, Singh says. 

Should everyone get monoclonal antibodies?

If you are healthy and are not showing symptoms, you might not need it. It is a limited resource. But as COVID-19 has surged in Central Texas, the state health department has been setting up an infusion center for monoclonal antibodies at the Travis County Expo Center.

Beginning this week there is now a coordinated effort through the Capital Area of Texas Regional Advisory Council to provide this service. It is giving it through a 60-minute IV treatment. A doctor still needs to send electronic orders to this done.

Previously, the treatments were done as outpatient services at hospitals and free-standing emergency rooms. 

How much does REGEN-COV cost?

That depends on your insurance and where you receive it. For people on Medicare, the cost is expected to be covered entirely by insurance. By federal law, other insurance plans they have to cover this treatment, but how much of it they cover depends on your policy and company. 

In July 2020 and January 2021, the federal government bought a supply of REGEN-COV to distribute just like it distributes the vaccines at no cost to patients. The cost to the government was $1,250 per dose. 

Why are monoclonal antibodies so important?

Monoclonal antibodies, Clitheroe says, "will reduce the amount of people who progress to critical illness in that second week."

That helps reduce the burden on the hospital system. The 11-county Central Texas hospital region has had as few as 1 intensive care unit bed left in the past week, and on Tuesday saw the most people on ventilators and in the ICUs with COVID-19 since the pandemic began.