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12/4/20 bs Covid positive outpatient treatment drugs update
December 7, 2020

From: "Berkley Sykes" <berkley.sykes@hhsys.org>
To: "Pharmacy Department" <grp_pharmacy@hhsys.org>
Sent: Friday, December 4, 2020 3:28:19 PM
Subject: covid positive outpatient treatment drugs update

We now have two different monoclonal antibodies being used to treat COVID-19 in an outpatient setting. Below I’ll summarize what we know today… please keep in mind that any of these processes can change at any time depending on drug supply, treatment locations, and other clinical and operational issues.

For a variety of reasons, we’re going to attempt to administer each of the two drugs in a different location.

Currently…

Fever and Flu Clinic: M-F, 8-5

Bamlanivimab only (located in BMT – count in carousel)

• BMT pharmacy is preparing batched doses which are delivered at scheduled times by courier. 6-9 patients seen in the morning and again in the afternoon.
• The OP scheduler in Cerner is utilized to determine number of doses required at any given time, but communication is between pharmacy and FFC is vital to ensure no drug is wasted.

Process summary:

Patient registered and drug ordered in Cerner the day prior. Order is verified by OPM pharmacist (usually), and then nurses pull drug from FFC refrigerator, scan label to ensure correct drug, and administer.

Beginning Monday, 12/7/2020…

Peds ED: anytime

Casirivimab (REGN10933) and imdevimab (REGN10987) only (located in HHWC carousel)

• HHWC pharmacy will prepare patient-specific doses when ordered by ED physician. Anticipated 2 pts/day.
• Comes as two vials with no drug names listed, only the REGN numbers noted above. Drug is being built in Cerner and flexed to HHWC and HHM, and recipe is being built in PKV. Please be very careful to ensure using correct vials during preparation.

Process summary:

Drug will be ordered while patient is in Peds ED. Drug will be verified and prepared, then delivered along with fact sheet to Peds ED and administered.

Future weekends are being considered for HHM or possibly FFC, but not ready yet. MH doses are not expected as those patients are being referred to the FFC.

In general:

• ED or on-site doses might not be scheduled ahead of time and will receive patient-specific prepared/labeled doses.
• FFC doses will be scheduled ahead of time and will receive batches whenever possible.
• We do not plan to batch REGN drugs unless we must.

We'll do our best to keep you posted. Let me know if you have questions!