Finding monoclonal antibody treatment depends entirely on what condition you need it for, and the landscape has shifted dramatically in the past few years. If you’re looking for COVID-19 monoclonal antibodies, most of the well-known options have been pulled from use because they no longer work against current variants. But monoclonal antibodies are still actively used for other conditions, including Alzheimer’s disease and RSV prevention in infants. Here’s what’s currently available and how to access it.
COVID-19 Monoclonal Antibodies: What’s Still Available
The monoclonal antibodies that became widely known during the pandemic are largely no longer authorized. The FDA has revoked or suspended authorization for nearly all of them. REGEN-COV (casirivimab and imdevimab) lost authorization in January 2022. Sotrovimab was pulled in April 2022. Bamlanivimab and etesevimab, administered together, had their authorization revoked in December 2023. Bebtelovimab is also no longer authorized. The reason is consistent across all of them: the Omicron variant and its subvariants evolved to evade neutralization by these treatments, making them clinically ineffective against circulating strains.
One product called Pemgarda (pemivibart) received emergency use authorization in March 2024 for pre-exposure prevention in certain immunocompromised individuals, though its authorization was updated in August 2024. For hospitalized adults with severe COVID-19, tocilizumab received full FDA approval in December 2022 and remains available, though this is a hospital-based treatment rather than something you’d seek out at an outpatient clinic.
If you’re currently sick with COVID-19 and looking for outpatient treatment, antiviral medications have largely replaced monoclonal antibodies as the standard option. The U.S. Department of Health and Human Services runs a treatments locator at treatments.hhs.gov where you can search by your location to find pharmacies, clinics, and other sites that carry COVID-19 and flu medications.
Alzheimer’s Disease Treatment Centers
Monoclonal antibody treatment for Alzheimer’s disease is a newer and rapidly growing category. Lecanemab received full FDA approval for patients with mild cognitive impairment due to Alzheimer’s disease or mild Alzheimer’s disease. It works by targeting and clearing amyloid plaques in the brain, which are a hallmark of the disease. It has not been studied in people without cognitive impairment or those with moderate-to-severe Alzheimer’s, so eligibility is limited to early-stage disease.
These infusions are offered at specialized neurology centers and academic medical centers rather than general clinics. UCLA, for example, runs a dedicated Amyloid Immunotherapy Care Program. Most major university hospital systems and large neurology practices now have similar programs or are building them. Your starting point is a conversation with your primary care doctor or neurologist, who can confirm your diagnosis, assess eligibility, and refer you to a center that administers the treatment.
Medicare covers lecanemab, but with a specific requirement: you must be enrolled in a registry approved by the Centers for Medicare and Medicaid Services. Your treatment center will typically handle this enrollment as part of the intake process, but it’s worth confirming before your first appointment.
RSV Prevention for Infants
Nirsevimab is a monoclonal antibody given to infants to protect against respiratory syncytial virus (RSV), which can cause serious lower respiratory infections in babies. It’s recommended for infants entering their first RSV season, generally those born since April of the current year and under 8 months old during peak RSV circulation. Unlike a vaccine, it provides ready-made antibodies in a single injection.
You can get nirsevimab through your child’s pediatrician or at a birth hospital before discharge. If your baby was born during or just before RSV season (typically fall through early spring), ask your pediatrician about it at a routine visit. No specialist referral is needed.
How to Get a Referral
For any monoclonal antibody treatment, you generally cannot self-refer. The process starts with your primary care doctor, a specialist, or in some cases an urgent care provider. They screen you to confirm you meet the eligibility criteria for the specific treatment, then refer you to an infusion center or clinic where the treatment is administered. An appointment is scheduled for you, often within days for time-sensitive conditions.
For COVID-related treatments specifically, eligibility has historically centered on people at high risk for severe illness. This includes people aged 12 and older (weighing at least 40 kg) who are immunocompromised, not fully vaccinated, or not expected to mount an adequate immune response to vaccination. People in institutional settings like nursing homes or correctional facilities who have been exposed to an infected person have also qualified. These criteria may shift as new products receive authorization, so your doctor is the best source for current eligibility.
What the Infusion Process Looks Like
If you’re referred for a monoclonal antibody infusion, the visit is straightforward and outpatient. The infusion itself takes 20 to 60 minutes depending on the specific treatment. After the infusion is complete, you’ll be monitored for about an hour to watch for any allergic or adverse reactions. Then you go home. The entire visit typically takes under two hours, and most people resume normal activities the same day.
Side effects are generally mild. The most common reactions are related to the infusion site (redness, swelling, or discomfort) or mild symptoms like headache, nausea, or fatigue. Serious allergic reactions are rare but are the reason for the observation period.
Cost and Insurance Coverage
Coverage varies by the type of monoclonal antibody and your insurance plan. For COVID-19 treatments, Medicare Part B covers monoclonal antibody products with zero out-of-pocket cost when you receive treatment from a Medicare-participating provider. This includes both treatment products and pre-exposure prevention products for people with weakened immune systems. If you’re enrolled in a Medicare Advantage Plan, your costs may differ, so check with your plan directly.
For Alzheimer’s treatments like lecanemab, Medicare coverage requires enrollment in a CMS-approved registry, as noted above. Private insurance coverage for these newer therapies varies widely. Some insurers cover them with prior authorization, while others are still finalizing their policies. Contact your insurer before starting treatment to understand your expected costs. The treatment center’s financial counseling team can often help navigate this process and identify any manufacturer assistance programs that may be available.