Michigan Medicaid: COVID-19 mitigation updates and toolkit
UnitedHealthcare Community Plan together with Michigan Department of Health and Human Services (MDHHS) continues to recommend the use of layered COVID-19 mitigation strategies for individuals. Vaccination, antivirals and pre-exposure therapeutics need to be incorporated into routine care for adults and children.
COVID-19 vaccination: Individuals should be up to date on their COVID-19 vaccine. Learn more about vaccines at Michigan.gov/COVIDVaccine.
Therapeutics: Health care professionals should determine whether an individual meets eligibility criteria to receive antibody or antiviral treatment if they test positive for COVID 19. Learn more about COVID-19 therapeutics below.
Antiviral medication is a treatment that kills a virus or suppresses its ability to replicate and, hence, inhibits its capability to multiply and reproduce. Antivirals are prescribed after a person has tested positive for COVID-19 and within 5 days of symptom onset. The most common antivirals used to treat COVID-19 patients include:
Paxlovid™: Given to treat mild to moderate COVID-19 in patients 12 years of age and older who are at high risk for progression to severe COVID-19, including hospitalization or death, and who meet the current Priority Eligibility Criteria.
Molnupiravir: Given to treat mild to moderate COVID-19 in adults ages 18 and older who are at high risk for progression to severe COVID-19, including hospitalization or death, and when alternative COVID-19 treatment options authorized by the Food and Drug Administration (FDA) are not accessible or clinically appropriate and who meet the current Priority Eligibility Criteria.
Remdesivir: Given to treat mild to moderate COVID-19 in individuals who are at high risk of disease progression. The use of it is initiated as soon as possible and within 7 days of symptom onset in those aged 12 years and older and weighing over 40 kg.
Monoclonal antibody therapies
Monoclonal antibodies are laboratory-produced molecules engineered to serve as substitute antibodies that can restore, enhance or mimic the immune system's attack on cells. Monoclonal antibodies are designed to block viral attachment and entry into human cells, thus neutralizing the virus. It is designed to limit viral replication and may be effective for the treatment of COVID 19 in patients who are at high risk for progressing to severe COVID-19 and/or hospitalization.
Monoclonal antibody treatment is for people who have tested positive for COVID-19 and have mild to moderate symptoms. When administered to non-hospitalized patients as soon as possible after positive viral testing for SARS-CoV-2 and within 7 days of symptom onset, monoclonal antibodies may reduce viral load, symptoms and risk of hospitalizations and emergency room visits associated with COVID-19.
Evusheld™ (tixagevimab + cilgavimab) On Dec. 8, 2021, the FDA issued an Emergency Use Authorization (EUA) for the medication Evusheld (tixagevimab/cilgavimab). Evusheld is a monoclonal antibody administered for pre-exposure prophylaxis (prevention) to those who are either immunocompromised and unable to receive the COVID-19 vaccine or who are not expected to mount a response to the COVID 19 vaccination.
Designed to block viral attachment and entry into the cells, Evusheld is a long-acting monoclonal antibody (mAb) therapy used for pre-exposure prophylaxis (PrEP) of COVID-19 in adults and children over 12 years and weighing at least 40 kg. Only individuals who have immunocompromise due to a medical treatment or condition are eligible to receive this medication. Individuals who have received the COVID-19 vaccine must wait at least 2 weeks before receiving Evusheld.
An EUA was issued from the FDA on Feb. 11, 2022, for the COVID-19 monoclonal antibody therapeutic bebtelovimab. The EUA allows health care professionals to administer bebtelovimab for outpatient treatment of mild to moderate COVID-19 in adults and children aged 12 years and older and weighing at least 40 kg, who are at high risk for progressing to severe COVID-19 and/or hospitalization.
The purpose of the COVID-19 Outpatient Therapeutics Toolkit is to provide a clinically focused overview of outpatient medications used to treat mild to moderate COVID-19. These treatments are intended for use in patients at risk for hospitalization or death and for pre-exposure prophylaxis (prevention) in certain people with moderate to severe immunocompromising conditions and for the few who have experienced a severe reaction to the COVID-19 vaccine. It is designed to provide clinicians with quick reference guides for each of the medications currently authorized for outpatient use. The medications in this toolkit include monoclonal antibodies (mAb) and antiviral therapies.