Table. Characteristics of Fee-for-Service Medicare Beneficiaries Receiving mAb Therapya.
| Characteristics | COVID-19 diagnosis/exposure, No. | Receiving mAbs, % | Adjusted OR of receiving mAbs (95% CI) |
|---|---|---|---|
| Total | 1 902 914 | 7.2 | |
| Age at first COVID-19 diagnosis, y | |||
| ≤64 | 305 163 | 4.9 | 0.67 (0.62-0.73) |
| 65-74 | 885 838 | 7.8 | 1 [Reference] |
| 75-84 | 501 432 | 7.8 | 1.30 (1.28-1.32) |
| ≥85 | 210 481 | 6.7 | 1.42 (1.39-1.45) |
| Sex | |||
| Female | 1 072 140 | 7.1 | 1 [Reference] |
| Male | 830 774 | 7.3 | 0.98 (0.97-1.00) |
| Race and ethnicityb | |||
| Black, non-Hispanic | 160 252 | 6.2 | 0.77 (0.75-0.79) |
| Hispanic | 123 998 | 6.7 | 1.16 (1.13-1.20) |
| White, non-Hispanic | 1 517 271 | 7.4 | 1 [Reference] |
| Other | 101 393 | 5.9 | 0.92 (0.90-0.95) |
| Medicaid | |||
| No | 1 402 371 | 8.1 | 1 [Reference] |
| Yes | 500 543 | 4.6 | 0.74 (0.72-0.75) |
| Region | |||
| Northeast | 374 960 | 5.9 | 0.50 (0.49-0.50) |
| Midwest | 516 424 | 6.5 | 0.51 (0.51-0.52) |
| South | 674 007 | 10.6 | 1 [Reference] |
| West | 329 249 | 2.9 | 0.22 (0.21-0.22) |
| Territories | 8274 | 3.1 | 0.05 (0.05-0.06) |
| Rural (non-MSA) | |||
| No | 1 319 013 | 7.0 | 1 [Reference] |
| Yes | 583 901 | 7.8 | 0.92 (0.91-0.93) |
| No. of chronic conditions | |||
| 0 | 178 064 | 23.2 | 7.43 (7.21-7.66) |
| 1-3 | 567 892 | 6.3 | 1.51 (1.48-1.55) |
| 4-5 | 448 857 | 6.0 | 1.30 (1.27-1.33) |
| ≥6 | 708 101 | 4.7 | 1 [Reference] |
| Current reason for eligibility | |||
| Aged ≥65 | 1 611 157 | 7.6 | 1 [Reference] |
| Disability | 282 393 | 4.9 | 0.95 (0.88-1.03) |
| ESRD | 7457 | 5.0 | 1.40 (1.23-1.60) |
| Both disability and ESRD | 1907 | 4.8 | 1.36 (1.08-1.71) |
| Alzheimer and related dementias | |||
| No | 1 638 509 | 7.8 | 1 [Reference] |
| Yes | 264 405 | 3.7 | 0.66 (0.65-0.68) |
| Chronic kidney disease | |||
| No | 1 304 033 | 8.2 | 1 [Reference] |
| Yes | 598 881 | 5.1 | 1.01 (1.00-1.03) |
| COPD | |||
| No | 1 613 857 | 7.7 | 1 [Reference] |
| Yes | 289 057 | 4.2 | 0.82 (0.81-0.84) |
| Heart failure | |||
| No | 1 542 703 | 7.8 | 1 [Reference] |
| Yes | 360 211 | 4.7 | 0.93 (0.92-0.95) |
| Diabetes | |||
| No | 1 305 110 | 7.8 | 1 [Reference] |
| Yes | 597 804 | 5.8 | 1.33 (1.31-1.35) |
| Ischemic heart disease | |||
| No | 1 254 879 | 8.0 | 1 [Reference] |
| Yes | 648 035 | 5.6 | 1.12 (1.10-1.13) |
| Stroke/transient ischemic attack | |||
| No | 1 805 635 | 7.4 | 1 [Reference] |
| Yes | 97 279 | 3.8 | 0.80 (0.77-0.83) |
Abbreviations: COPD, chronic obstructive pulmonary disease; ESRD, end-stage renal disease; mAb, monoclonal antibody; MSA, metropolitan statistical area; OR, odds ratio.
See Methods section of text for codes used to identify mAb infusions and COVID-19 diagnoses. Patients hospitalized or deceased within 7 days of COVID-19 diagnosis were excluded. Data include patients from 50 states, the District of Columbia, and US territories except those residing in Guam or the Marshall Islands on January 1, 2021 (excluded because all beneficiaries in these territories either received or did not receive mAb therapy). Age data are age at time of COVID-19 diagnosis. Chronic conditions listed are those recognized as risk factors for severe COVID-19 outcomes. Model controlled for variables listed as well as state indicators and additional chronic conditions. The full list of 27 chronic conditions included acute myocardial infarction, Alzheimer disease and related disorders of senile dementia, atrial fibrillation, cataracts, chronic kidney disease, COPD, heart failure, diabetes, glaucoma, hip/pelvic fracture, ischemic heart disease, depression, osteoporosis, rheumatoid arthritis/osteoarthritis, stroke/transient ischemic attack, breast cancer, colorectal cancer, prostate cancer, lung cancer, endometrial cancer, anemia, asthma, hyperlipidemia, benign prostatic hyperplasia, hypertension, and acquired hypothyroidism.
Beneficiary race and ethnicity were defined using the Research Triangle Institute classification available in the Medicare Master Beneficiary Summary File. The “other” category includes Asian and Pacific Islander, American Indian and Alaska Native, and beneficiaries coded as “other” or “unknown” in the beneficiary race code. Race and ethnicity were included in this analysis to assess differences in rate of mAb receipt across racial and ethnic groups.