Scott Gottlieb says states could struggle with logistics

Dr. Scott Gottlieb on Wednesday raised concerns about the smooth delivery of Covid-19 vaccines over the next year when shots become available for Americans who are not health care workers or residents of long-term care facilities.

The former Commissioner of the Food and Drug Administration pointed out the challenges Reportedly experienced The administration of antibodies to Americans could suggest that these difficulties could create similar difficulties for vaccines.

“The experience with the antibodies is not a good harbinger,” said Gottlieb on CNBC’s “Squawk Box”. “When we get into the next batch of people to be vaccinated, which is going to be in the community, states might find it difficult to distribute those vaccines if they can’t distribute the antibody drugs.”

According to CNBC’s Meg Tirrell, only 5% to 20% of antibody drugs shipped to the US have been used to treat people infected with the coronavirus but not hospitalized. The FDA last month granted emergency use approval for Eli Lilly and Regeneron’s antibody drugs. Treatments must be given through an IV, which is likely a major hurdle contributing to underuse.

Gottlieb, a board member for Pfizer, which makes the only FDA-approved Covid-19 vaccine currently, said the antibody drug challenge is a last-mile problem for states. In other words, it directly connects the range of treatments available to people in the community who need them. There are examples of where this is done well, such as in Maryland where special infusion sites have been set up, Gottlieb said.

But for the most part, he said, “I think states are inherently resource constrained and there is probably more that the federal government could do to stop the states.” He said he believed it could be a last mile problem for the vaccines as well.

Adding to Gottlieb’s concern about whether available vaccine doses will ultimately reach those eligible for immunization is that each state can have its own approach. Currently, states are prioritizing health workers and residents of long-term care facilities with their initial vaccine allocation.

As availability increases – which Gottlieb expects next month – the number of people eligible for vaccination may expand to other key workers and older Americans who do not live in nursing homes or assisted living facilities.

“I think most states will do a mix of the two, but then … if you try to go to the community to actually deliver the vaccines like they do, you will find a tremendous amount of heterogeneity” said Gottlieb. who headed the FDA in the Trump administration from 2017 to 2019.

“I think you will find some big differences in accessibility between states, and again the antibody drugs herald that,” he added. “If we go out of this up to 50 states, we can expect that there will be a lot of differences in how well this is going and who gets access to it and who doesn’t, and that will be unfortunate because in an ideal world you want to see more consistency . “

Disclosure: Scott Gottlieb is a CNBC employee and a member of the boards of directors of Pfizer, the genetic testing startup Tempus, and the biotech company Illumina. Gottlieb is also co-chair of Norwegian Cruise Line Holdings and Royal Caribbean’s Healthy Sail Panel.