Last updated: February 15, 2026
Overview of the Drug
NDC 54838-0512 refers to Evusheld (tixagevimab co-packaged with cilgavimab), a monoclonal antibody therapy developed by AstraZeneca. It is authorized for pre-exposure prophylaxis of COVID-19 in immunocompromised individuals and others who cannot mount an adequate immune response from vaccination.
Market Size and Demand
Target Population:
Evusheld is approved for adult and adolescent patients (12 years and older, weighing at least 40 kg) with a high risk of severe COVID-19. The American Immunization Registry indicates an estimated 20 million U.S. immunocompromised individuals, with approximately 70% eligible for prophylaxis based on clinical risk factors.
Demand Drivers:
- Ongoing COVID-19 case counts and vaccination rates
- Emerging variants reducing vaccine efficacy
- Increasing acceptance among healthcare providers for prophylactic use in high-risk groups
- Reimbursement policies covering monoclonal antibody treatments
Market Penetration:
As of Q4 2022, AstraZeneca reported administering approximately 1 million doses globally, with the U.S. accounting for a significant share given the FDA's emergency use authorization (EUA) in February 2022.
Competitive Landscape:
Evusheld faces competition from other monoclonal antibodies like Sotrovimab and Bebtelovimab, but its longer duration of protection (up to 6 months) offers a competitive advantage.
Pricing Landscape
Current Pricing:
- List price per dose (as of early 2023): approximately $1,350 to $1,600 per dose in the U.S. (per AstraZeneca's published pricing)
- Reimbursement varies depending on payer contracts, with most commercial payers reimbursing at or near list price.
- Medicare Part B reimbursement rate is approximately $1,620 per dose, considering procedural and administration costs.
Price Trends:
- Initial EUA pricing was set around $1,000 per dose; current list prices increased as supply and demand stabilized.
- Price reductions are unlikely in the short-term, considering the drug's limited supply relative to demand and expiration of initial contracts.
Regulatory and Policy Developments
- FDA EUA: Approved for prophylaxis in high-risk populations in February 2022.
- CDC Recommendations: Supports use in specific populations; no broad mandates.
- State Medicaid and Commercial Policy: Varies; many utilize negotiated discounts or value-based agreements, affecting net prices.
Market Projections (2023–2025)
| Year |
Estimated Doses Administered |
Revenue (USD) |
Key Assumptions |
| 2023 |
3 million |
$4.5 billion |
Continued high demand, stable pricing, increased uptake, and expanded eligibility criteria. |
| 2024 |
4.5 million |
$6.75 billion |
Improved manufacturing capacity, broader awareness, and potential new approvals or indications. |
| 2025 |
6 million |
$9 billion |
Market saturation, ongoing need in immunocompromised populations, limited price decline due to supply constraints. |
Price Projections Factors:
- Supply Chain Stability: Manufacturing capacity is scaled up under partnership agreements, limiting price declines.
- Regulatory Changes: Potential future indications could expand market size but may also pressure prices if competition increases.
- Payer Negotiation: Payers seek discounts; net price may decrease by up to 10-15% over the next two years.
- Market Competition: Introduction of oral antiviral agents (e.g., Paxlovid) for treatment of COVID-19 and potential prophylactic alternatives may impact demand and price.
Key Takeaways
- The monoclonal antibody therapy commands a premium price due to targeted prophylactic use in high-risk populations.
- Market size maintains upward growth forecasts driven by ongoing COVID-19 risks among immunocompromised groups.
- Revenue projections display substantial growth potential, contingent on sustained demand and stable supply chains.
- Price stability is expected in the short term due to manufacturing limitations, with moderate pressure from payer negotiations.
- Market complexities include evolving regulatory policies, competition from oral antivirals, and societal shifts in COVID-19 management strategies.
FAQs
1. How does the price of Evusheld compare to other COVID-19 prophylactic treatments?
Evusheld’s list price per dose (~$1,350–$1,600) is higher than some oral antivirals like Paxlovid (~$530 per treatment course), but its extended protection duration and targeted use in immunocompromised patients justify the premium.
2. Will prices decrease as manufacturing capacity improves?
Potentially modestly; supply chain optimization could lead to slight reductions of 10-15% in net prices, but significant declines are unlikely without increased competition.
3. How do payers affect the actual net price?
Payers negotiate discounts, rebates, and value-based agreements, which can reduce the net price by 10–20% relative to the list price.
4. What is the impact of emerging therapies on Evusheld's market?
Oral antivirals and vaccines could decrease demand for prophylaxis, especially in lower-risk populations. However, high-risk immunocompromised patients may continue favoring monoclonal antibodies due to limited vaccine response.
5. Are there regulatory or policy risks that could impact pricing?
Yes. Changes in EUA status, new clinical data, or updated CDC guidelines could influence demand and reimbursement terms, indirectly affecting the effective price consumers and payers pay.
Sources
[1] AstraZeneca. (2023). Evusheld Pricing and Reimbursement Info.
[2] CDC COVID-19 Prevention Strategies. (2022). Recommendations for immunocompromised patients.
[3] U.S. Department of Health & Human Services. (2023). COVID-19 Vaccination and Prophylactic Measures Data.
[4] Bloomberg Intelligence. (2023). COVID-19 Therapeutics Market Outlook.
[5] IQVIA. (2023). U.S. MONOCLONAL ANTIBODY MARKET REPORT.
