When UPMC was short on COVID-19 monoclonal antibody Evusheld, the Pittsburgh-based system assembled a weighted lottery for equitable care, according to a study published Sept. 1 in JAMA.
The lottery was designed to mitigate health disparities in Black and disadvantaged communities, according to the research. A disadvantaged population was defined by a score of 80 or greater on the Area Deprivation Index, which measures 17 deprivation indicators that are linked to poor health outcomes.
To equitably divvy up 450 available Evusheld doses across the 35-facility system, UPMC put patients' names in twice if they were from disadvantaged areas. About 10,000 people were eligible for the lottery, including 1,800 patients from disadvantaged neighborhoods and 767 Black patients.
Compared to a simulated, unweighted lottery, UPMC's strategy saw a greater proportion of Black people allocated the drug, or 7.1 percent to 9.1 percent. Black patients were less likely to accept the drug than white patients, though, indicating a need for more equitable care plans, the researchers concluded.
The lottery lasted from Dec. 8, 2021, to when Evusheld supply rebounded on Feb. 23, 2022. In Early 2023, the FDA revoked its emergency use authorization for Evusheld after the virus evolved past the monoclonal antibody's efficacy.