Private hospitals in Bengaluru persist with cocktail therapy

Manufacturers have stated that it has diminished efficiency against Omicron

Patients treated for Covid-19 in private hospitals within the first week of their illness continue to get monoclonal antibody or cocktail therapy despite the manufacturer’s warning that it has diminished efficiency against Omicron.

Patients spend Rs 1.2 lakh on the double-dose, single-pack vial manufactured by Regeneron Pharmaceuticals that said in a statement on December 16 in the wake of rising Omicron cases that the therapy would not be potent against the latest variant of the novel coronavirus.

Monoclonal antibodies are laboratory-made proteins that mimic antibodies to evoke a faster immune response in the body against SARS-CoV-2 (the virus that causes Covid-19) and stop the disease from getting severe. The cocktail is intravenously administered in the OPD in two to four hours.

Read more: Karnataka may see 20-70K daily hospitalisations by February 2: Report

Dr Murali Mohan, Pulmonologist, Narayana Health, said his hospital had been using less of monoclonal antibodies since Omicron’s emergence. “Earlier it was Delta, but now we are not sure about (its efficacy against) Omicron (variant),” he said. “Although we administered it (in the past), we are a little more cautious.”

From November last week to December third week, the hospital gave the cocktail therapy to 20 patients, but the number of patients getting the therapy has reduced. “Most are getting better without treatment unless they have other risk factors."

The standard risk factors include being aged above 65, uncontrolled diabetes, hypertension, obesity or systematic problems with kidneys, heart or lungs.

Most patients who got the therapy in December before the Omicron surge became better in a couple of days. None of them was hospitalised.

“We had a 95-year-old man and his daughter who were given the cocktail,” Dr Mohan said. “Since nobody else was taking (the therapy), we gave it to the family member instead of wasting it (though she didn’t qualify or need it) as they are paying Rs 1.2 lakh.”

Regeneron Pharmaceuticals’s REGEN-COV contains two antibody vials Casirivimab and Imdevimab, which are blended and administered to patients.

Manipal Hospitals’ Chairman and Intensivist-Critical Care, Dr Sunil Karanth, said his hospital administered the therapy to just four ICU patients after the Omicron surge. “Otherwise, it is meant for mild and moderate cases before they reach ICU,” he said. “Studies showed 70% reduction in the disease’s progress in severity. We know the company said it has diminished potency, but we don’t know if it has no potency (at all).”

He said most centres give the therapy in the absence of anything better, while it might work on some patients who may have Delta. “We know it’s not a part of government guidelines and costs Rs 65,000 per patient."

Apollo Hospitals, Jayanagar, medical superintendent Dr Govindaiah Yatheesh revealed his doctors’ opinion that cocktail therapy has no effect on Omicron. Chairman of state clinical expert committee Dr K Ravi said Karnataka’s Covid-19 treatment protocol did not include administering cocktail therapy for Omicron patients.

Rajarajeswari Medical College and Hospital had given the therapy to six patients since December 23 pricing Rs 60,000 per dose. While four patients were elderly, two younger patients demanded to take the therapy.

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