Alberta stockpiles at-home COVID-19 treatments, ponders expanding eligibility

As shipments containing thousands more doses of the outpatient COVID-19 treatments Sotrovimab and Paxlovid arrive in Alberta, the provincial government says it may consider expanding who is eligible for them.

This comes at a time when Alberta has lifted nearly all public health restrictions.

Experts warn while demand will likely rise for these specialized therapies in the coming weeks — and they can help in some high-risk situations — they should not be considered a replacement for COVID-19 vaccines.

Sotrovimab and Paxlovid, which are both offered outside of hospitals, are available to a narrow group of high risk Albertans who've tested positive through PCR testing and are unvaccinated, or have received just one dose.

This group includes people over the age of 55, those with certain underlying health conditions — such as diabetes, chronic obstructive pulmonary disease (COPD), obesity and heart failure, and those who are pregnant.

Both vaccinated and unvaccinated people who are immunocompromised due to transplants or treatments for illnesses such as cancer and inflammatory diseases, including rheumatoid arthritis and lupus, are also eligible.

Both treatments are designed to treat mild to moderate COVID-19 and must be given within five days of symptoms starting. 

According to Alberta Health Services (AHS), as of March 2, 1,349 intravenous infusions of Sotrovimab have been administered since the monoclonal antibody treatment became available in November.

AHS also said 213 prescriptions for the oral antiviral medication Paxlovid have been handed out in the first month it has been offered.

The health authority said 235 of the people who received the treatments were either unvaccinated or had just one dose of the vaccine. 

"These therapies aren't for everyone," said  Dr. Alain Tremblay, a respirologist at Calgary's Foothills Medical Centre and a member of the COVID therapeutics working group, which advises public health officials on COVID-19 treatments.

According to Tremblay, these treatments are expensive, difficult to administer, they come with side effects and they can interact with other drugs.

"If you're fully vaccinated, your chance of a severe endpoint is quite low. So you don't really need to get those treatments, which is even better than being unvaccinated, falling sick and then needing these therapies that are a hundred times more expensive than the cost of a vaccine."

However, Tremblay said, Sotrovimab and Paxlovid can be useful for immunocompromised and unvaccinated individuals.