covid-19 state medical societies collaborative

COVID-19 STATE MEDICAL SOCIETIES COLLABORATIVEWEBINAR AGENDAMonday February 22, 2021

AGENDA

Update on COVID-19 Antibody Therapy Access and Payment

Arizona Survey on COVID Vaccines

Update on COVID-19 CME/CE Programs

Resources, Recordings

Next Meeting 03/08 3pm Eastern – Lessons learned setting up medical practices to conduct vaccine clinics

ABOUT COVID-19 STATE MEDICAL SOCIETY COLLABORATIVE

SMS COVID-19 Collaborative

Started March 2020

Bi-Weekly Meeting

25 COVID-19 CME webinars and online courses in 2020 reaching 20,000+ clinicians

UPDATE ON COVID-19 ANTIBODY THERAPY ACCESS AND PAYMENT

Connie Sullivan, B.S.PharmPresident & CEO National Home Infusion Association (NHIA)

[email protected]

Brian Nyquist, MPHPresident & CEONational Infusion Center Association (NICA)

[email protected]

NHIA SPEED ProgramConnie Sullivan, BSPharm

President and CEO

[email protected]

Agenda

Bamlanivimab overview

Program Overview

Provider Statistics

Lessons Learned/Future Outlook

Bamlanivimab• Initial EUA issued November 9, 2020• Approved for treatment of mild-

moderate COVID-19 in non-hospitalized, high-risk adults and peds (>12 years and weighing >40kg)

• 700mg/NS IV over 16 to 60 minutes using set w/ 0.22mcn filter, requires 1 hour post-infusion monitoring for ADEs (no pump needed)

• Dose must be given within 10d of symptom onset

• Once prepared, store 24h RF, 7h RT• EUA revised for additional warning-

possible clinical worsening, and/or infusion-related hypotension

Ref: Bamlanivimab EUA Healthcare Provider Fact Sheet‐20201109, www.bamlanivimab.com

NHIA SPEED Program ObjectivesObjectives:1. Improve access to bam for individuals in

LTC and other high-risk settings2. Facilitate allocations of bamlanivimab to

home infusion providers willing to administer to high-risk individuals residing in LTC or other high-risk settings.

3. Collect data

As of today:• Individual Pharmacy Locations: 172• Geographical Coverage

• 46 States

Project Timeline

Concept 12/7/2020

Launch 12/14/2020

First Infused Dose 12/23/2020

SC1RG1RG2

SC1 I would remove "Total" bar from these graphs as it skews the y axis. I think data labels also help. I don't have access to the original excel file to fix this myself.Sullivan, Connie, 1/28/2021

RG1 Ok got it

Ryan Garst, 1/28/2021

RG2 I will total N in the title for referecne

Ryan Garst, 1/28/2021

Home Infusion

• NHIA SPEED Program is limited to facility-based administration

• For Medicare patients, CVS Coram offers a pilot program in 7 metro markets

• Most providers do not have access to product for home administration

• NHIA has petitioned CMS to increase the payment rate for COVID-19 mABs when administered at home

• Current rate of $309 does not cover the cost to provide the service

• Most commercial plans are basing payment on Medicare rates

Program Information

Developed Online Enrollment Process

Verified licensure & accreditation

Created Dedicated Website

Physician Ordering and Billing Tools

Weekly Office‐hours for updates, Q&A

Data Tracking and Reporting

Promotion via email and e‐newsletters

Open to both members and non‐members of NHIA

www.nhia.org/news/bam‐pilot‐program/

Program Statistics • 3429 doses allocated• 396 doses administered (11.5%)• 80 unique facilities

• SNF - 66%, ALF- 31%, Other - 3%• 48% in communities <25,000 pop.

• 88% of doses to persons >65 yrs.

Time from Symptom Onset to Bamlanivimab Infusion

n Min Max Mean Std. Deviation

# of Days Between Symptom Onset and

BAM Infusion

114 1 14 4.04 2.42

33%

64%

3%

Location of Administration

Assisted Living Skilled Nursing Other

Patient Demographics

Mean Age (n=223) 81.95 (SD=11.88)Range 45 ‐ 101

Gender (n=223) M = 71 F = 152

Ethnicity (n=116) African/American = 5 White = 111

Outcomes

(n=223)• 92.83% of patients reported no

infusion‐related side effects • No serious adverse events • 2 report of hospitalizations• 1 infusion stopped after 15 minutes• 2 deaths, un‐related to infusion

ADR Type Frequency Percent

None 207 92.83

Hypotension 4 1.79

Fever 3 1.35

Other 2 .90

Diarrhea 1 .45

Fever 1 .45

Flushing 1 .45

Headache 1 .45

Headache, Nausea, Fatigue

1 .45

Chills 1 .45

Pruritis 1 .45

Total 223 100.00

Patient # Age Gender Date of COVID‐19 Symptom Onset

Date of COVID‐19 Positive Test

Risk Criteria

48 86 Female 12/28/20 12/31/20 65 yrs. or older53 86 Male 12/28/20 01/01/21 65 yrs. or older

Lessons Learned & Future Outlook

• Participation in NHIA SPEED program demonstrates home infusion provider enthusiasm for providing bam in their communities

• Providers with pre-existing relationships with LTC are most successful with SPEED• Demand for home infusion now exceeds that of facilities as vaccines become

accessible, however Medicare payment is a barrier• Ongoing need for COVID-19 mABs for patients who can’t be vaccinated, non-

responders• May have prophylactic value

Open Access Report: A Home Infusion Program for Administration of Bamlanivimab in High-Risk Settings

© 2021 National Infusion Center Association. All rights reserved.

NATIONAL INFUSION CENTER ASSOCIATION

14 © 2018 National Infusion Center Association. All rights reserved.

NATIONAL INFUSION CENTER ASSOCIATION COVID‐19 MONOCLONAL ANTIBODY RESPONSE

INFUSION SITE LOCATOR DEMONSTRATION



NICA BACKGROUND• Nonprofit advocacy organization supporting the nation’s non-hospital, community-

based infusion centers.

• Mission: Improve access to provider-administered medications.

• Approach: Support the sustainability, optimization, and expansion of the community-based infusion delivery channel.

• Goal: Ensure that our nation’s sickest and most vulnerable citizens requiring provider-administered medications can access the right medication, at the right time, in a safe and cost-effective setting.

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**NICA does not own, operate, manage, or otherwise have financial stake in any infusion operations**



CmAb Response Goals

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Improve uptake of COVID antibody therapies

Help more patients find COVID antibody infusion sites

Build awareness of COVID Antibody Locator tools

Engage with community-based infusion centers

Expand the COVID antibody infusion site footprint



DISCUSSION OBJECTIVES

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Overview of the NICA COVID Antibody Site Locator tool Challenges with antibody integration Design Principles Demo & compare to OWS/HHS tool

Data considerations Site eligibility Ability to claim and manage site-level data

Engaging with / supporting stakeholders Engaging community-based infusion providers Getting sites to “claim” and enhance profile data



Challenges Facing COVID mAb Integration

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Patient Integration

Safely integrating COVID-positive patients with

immunocompromised, non-positive patients

Access FootprintIdentifying phase 2 sites;

enabling & expanding infusion capacity in key markets and underserved communities

Economics

Sufficient reimbursement to cover the practice expenses of

care coordination

Identifying Infusion Sites

Prescriber identification of infusion sites that received

allocation of mAbs

Resourcing Expanded Capacity

Availability of staff, supply, and financial resources to

invest in capacity expansion



NICA INFUSION CENTER LOCATOR

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6,000 infusion centers across all 50 states, DC, and Puerto Rico

Purpose-built and improved over 5 years

Most widely-used resource for identifying sites of care

Major insurers use to drive site of care optimization

Limitless scalability supports thousands of searches per day

Sites can claim location profile to update and manage content



NICA COVID ANTIBODY LOCATOR

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Product agnostic & loaded with non-sensitive, public-facing sites

Prioritization of results does not show favoritism of therapies

Interstitial messaging upon accessing the site

Manufacturer involvement/support recognized via logo display

Does not currently provide indicator of site-level inventory status

GOAL: Support integration of COVID-19 antibody therapies by providing a comprehensive, user-friendly, state/site managed antibody site locator tool.

Design Principles:



NICA COVID ANTIBODY LOCATOR

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Developed upon existing Locator infrastructure

Provides richer site information for rapid engagement

Amerisource Bergen ship-to data curated for public consumption

Sites may manage their location’s profile information

Includes all non-sensitive sites that received allocation

State-level validation and weekly data maintenance updates

https://covid.infusioncenter.org



NICA COVID ANTIBODY SITE LOCATOR

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Auto-lists sites within 30-miles

Search radius: 5 miles to 100 miles

Filters are hidden to only display COVID antibody sites

Users can access profiles through map icons or search results

“Verified” status display

https://covid.infusioncenter.org



NICA COVID ANTIBODY SITE LOCATOR

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Instructions for HCPs and patients

Consumer-friendly contact info

Click-to get directions

Sites can claim location profile to update and manage content

COVID contact information

Crowd-sourced feedback form



SITE EXCLUSION CRITERIA

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SITE TYPE EXAMPLES (Raw ABC Data) ACTIONCentral Receiving or “Depot” sites UNC Depot

HealthOne Denver[Health system] GPOINTERMOUNTAIN SCC ACUTE SVCS PHCY

Resolve with State

Government Sites Department of state[State] dept of health (or public health warehouse)Department of Defense[State] hospital

Resolve with State

Military Sites Womack Army Medical CenterNaval Hospital Camp Pendleton

Removed

Prisons Florida Lake Butler Prison Removed

Unknown Supply Chain or Unresolvable Address FAR WEST SUPP CH SRV EDI #113ST UNIV OF NY AT STONY BROOK

Resolve with State

Pharmacies Resolve with State

Long-Term Care Facilities Removed



“CLAIMING” A SITE PROFILE

“Unclaimed” label in a profile denotes active sites with profiles that have not been claimed and updated

Claimed profiles may be updated in real time Name, address, phone #, email, hours of operation, special

instructions, etc.

Instructions for claiming and updating a site: https://infusioncenter.org/how-to-claim-add-and-edit-infusion-center-listing/

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“CLAIMING” A SITE PROFILE ‐ CHALLENGES

Locator uses a password-less log-in workflow After claiming a site, users must enter their email to log-in They receive an email that includes a verification link, providing

access

Spam filters & IT configuration at health systems

Sites may whitelist “@infusioncenter.org” domain

If issues persist, sites may contact [email protected] support

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HOW THE MEDICAL COMMUNITY CAN HELP? Educate patients on CmAbs & share success stories

Use publicly available resources (e.g., CmAb infusion site locator)

Share useful resources across the medical community

Build relationships with infusion providers in your community

Use crowd-source feedback form help keep information up-to-date

Build prescriber and patient confidence

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NICA COVID ANTIBODY THERAPY RESOURCES

Order sets for consistent prescribing per EUA criteria

Checklist to determine and document patient eligibility

Referral checklist to reduce delays in patient referral

“How to prepare for a COVID antibody infusion”

Tables for calculating drip rates for both therapies

FAQs & Discharge instructions

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https://infusioncenter.org/infusion_resources/covid-19-antibody-treatment-resource-center/

QUESTIONS?

SURVEY RESULTS ARIZONA DEPARTMENT OF HEALTH SERVICES

VACCINE SURVEY OF HEALTHCARE WORKER AND THE GENERAL POPULATION November 16 – 30, 2020..

18,915 HCP Responses

1,500 General population responses

HCP: LIKELIHOOD OF GETTING A COVID-19 VACCINE

More than half of HCPs would likely get an FDA-approved vaccine to prevent COVID-19

REASONS FOR TAKING THE VACCINE

Trust in the vaccine is almost as frequently cited as protecting self and others as a reason for taking the vaccine

REASONS FOR NOT TAKING THE VACCINE

One third of those who would not take the vaccine cite lack of data (untested/rush and not enough data/research) as the reason.

Further education about COVID-19 vaccines may address vaccine hesitancy among HCPs

TRUSTED SOURCES OF INFORMATION ABOUT COVID-19 AND THE VACCINE

Among HCPs the most trusted sources of information are their personal physician and the CDC

The importance of physicians being knowledgeable about COVID-10 vaccines cannot be underestimated

IMPACT OF MESSAGING ON HCP COVID-19 VACCINE ACCEPTANCE

Reminding HCPs that vaccines protect others has a positive impact on their vaccine compliance

GENERAL ARIZONA POPULATION: LIKELIHOOD OF GETTING COVID-19 VACCINE

More than half are likely to get a COVID-19 vaccine

GENERAL ARIZONA POPULATION: ENCOURAGEMENT FROM OTHERS TO GET VACCINATED

Encouragement from their physician or someone who has had the vaccine has a positive influence on the decision to be vaccinated

GENERAL ARIZONA POPULATION: IMPACT OF MESSAGING ON VACCINE ACCEPTANCE

An altruistic message improved vaccine acceptance

UNMET NEED

Provider education on antibody therapies

Education on MOA of vaccines

Whom to contact to obtain COVID-19 vaccines

Setting up EMR reminders especially for second doses

How to address vaccine hesitancy

Patient-level education materials (handouts, posters, websites)

Risk of vaccine side effect compared to risk of disease (relative risk)

How to discuss vaccine with patients

Testimonials are important from people who have been vaccinated (ask those who have had both doses to share their experience with friends, post on social media)

The message that getting vaccine protects others (family, co-workers, patients) is important, it resonates with HCPs and the public

NEW ONLINE COURSES NOW AVAILABLE

www.rockpointe.com/COVIDDerm http://www.rockpointe.com/COVIDDiabetes

https://www.rockpointe.com/courses/telemedicine‐in‐asthma‐management‐what‐clinicians‐need‐to‐know/

https://www.rockpointe.com/courses/obesity-and-covid-19-in-the-outpatient-setting-what-clinicians-need-to-know-2/ www.rockpointe.com/COVIDLung

TUESDAY, MARCH 16, 20214:00 - 5:00 PM ET (3:00 - 4:00 PM CT / 1:00 - 2:00 PM PT)

WEDNESDAY, MARCH 24, 20217:00 - 8:00 PM ET (6:00 - 7:00 PM CT / 4:00 - 5:00 PM PT)

THURSDAY, APRIL 15, 202112:00 - 1:00 PM ET (11:00 AM - 12:00 PM CT / 9:00 - 10:00 AM PT)

https://www.pathlms.com/rockpointe/courses/27637

https://www.rockpointe.com/state-medical-society-collaborative/Recordings, Slides, Resources

LESSONS LEARNED FOR MEDICAL PRACTICES RUNNING COVID VACCINE CLINICS (MARCH 8TH. 3PM EASTERN)

GINO TABET, MBADIRECTOR OF BUSINESS INTELLIGENCEFLORIDA COMMUNITY HEALTH CENTERS

STEPHANIE TURNERCENTER ADMINISTRATIVE DIRECTORFLORIDA COMMUNITY HEALTH CENTERS

FUTURE PROGRAMS INCLUDESETTING UP MASS VACCINATION CENTERSMENTAL HEALTH RESOURCES FOR YOUR CLINICIANSOVERCOMING THE BARRIERS OF MENTAL HEALTHVIRAL VECTOR VACCINES – NEXT GENERATION COMING

Next TOPICS

CONTACTS

Thomas [email protected]

Frank BerryMEDCHI410-539-0872 x 3307 [email protected]

covid-19 state medical societies collaborative

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