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The Utah Health Department awarded a $750,000 contract to Nomi Health to run a monoclonal antibody treatment facility in Utah County, using a provision in state law allowing it to give a contract to Nomi without allowing other companies a chance to compete for it.
A “trial use” contract allows the state to skip the normal procurement process if it is for something deemed “new or innovative.” Monoclonal antibody treatments, which use artificially created proteins to mimic the body’s immune reaction, have been effective in treating some cases of COVID-19.
The contract will pay Nomi Health $125,000 per month for six months. After that, the state can decide to continue the program and give other companies a chance to bid. The Nomi facility opened on Oct. 25.
Nomi has been the subject of much controversy since the early days of Utah’s COVID-19 response. The company operates TestUtah, which had an unusually low number of positive tests early in the pandemic. The state stopped investigating before determining the reason for the discrepancy, but later required TestUtah to use a different test and a different processing lab. Its tests also cost the state more than other testing solutions.
Nomi was awarded more than $5 million in no-bid contracts at the start of Utah’s COVID-19 response. The total value of Nomi’s contracts with the state since 2020 is more than $43 million.
There are nearly 60 other monoclonal antibody treatment centers already in operation in Utah.
Connecting positive cases to treatment centers
In September, UDOH handed off nearly all of the COVID-19 testing sites it had been running to TestUtah, the initiative launched last year by a consortium of tech companies. Nomi Health holds the TestUtah contract and operates nearly 40 testing sites across the state. Nomi will contact Utahns who test positive for COVID-19 to assess whether they might benefit from the mAb treatment.
“For mAb therapy to benefit a patient, it must be administered soon (within 7 days) after the patient exhibits symptoms and tests positive. As the operator of TestUtah, Nomi is uniquely positioned to contact these patients quickly and help determine if mAb therapy may be beneficial,” Health Department spokesperson Tom Hudachko said.
The state uses a matrix to determine which COVID-19-positive Utahns would be eligible for mAb infusion. Nomi will handle referrals for monoclonal treatments while also operating a facility that offers the treatment. Hudachko says UDOH doesn’t anticipate Nomi directing patients to its own facility over other options, and there would be no financial incentive to do so, as Nomi would not be reimbursed on a per-treatment basis.
“Patients will be made aware of all treatment location options and the patient ultimately makes the final determination on where they receive treatment,“ Hudachko said. “Nomi patients can receive treatment at any mAb administration site, and conversely, non-Nomi patients can receive treatment at the Nomi site.”
Officials were left in the dark, emails show
The decision to use Nomi for trial use contract alarmed Senate President Stuart Adams, R-Layton, who has been an outspoken advocate for monoclonal antibody treatment as a way to reduce the strain on Utah’s hospitals.
According to emails obtained by The Salt Lake Tribune through an open records request, Adams expressed concern when Senate chief of staff Mark Thomas informed him of an upcoming tour of the facility for lawmakers.
“Are you aware of an RFP for those services? This is the first I have heard of NOMI doing this. I thought the State and Local Health Departments and local hospitals were setting this up,” Adams wrote on Sept. 27.
Later in the email chain, Adams tells Thomas that he spoke with Gov. Spencer Cox about monoclonal antibody treatment, and was surprised that he did not bring up the Nomi facility in Utah County.
“I told him the media and others would continue to try and tie the monoclonal treatment and hydroxychloroquine together to undermine the effort. When the media raised questions about the procurement, no-bid contracts, cost, and it got bad, everyone ran for cover,” Adams wrote.
UDOH confirmed to The Tribune that Gov. Spencer Cox was briefed on the decision to give Nomi a trial use contract for the Utah County facility, but Cox’s office had “no direct involvement” in the decision.
Adams told The Tribune he’s worried past controversies surrounding Nomi’s involvement in the state’s COVID-19 response will take the focus off a valuable treatment option.
“The public needs to know about monoclonal antibodies. My focus is on saving people’s lives. I’m passionate about using every tool possible,” Adams said.
It wasn’t just Adams who was unaware of the Nomi facility in Utah County.
“Utah County Commissioner Amelia Powers Gardner reached out on Facebook last week asking how Utah county can set up a monoclonal treatment center. I referred her to the county health official. I’m confused why I’m just learning about this Nomi treatment center and county officials also appear to be in the dark,” Adams wrote.
The federal government controls the supply of mAb available for each state. Last week Utah received 2,050 doses. Every week health care providers inform UDOH of how many mAb treatments they’ve used and how many remain in stock. The state submits then submits orders to the federal government.
“Currently, all partners are receiving their full requested amount each week. However, if at some point requests exceed the allocation, sites may only receive a percentage of the total they request,” Hudachko said.
Funding for the contract will come from federal COVID-19 relief money through the CARES Act.
Nomi Health responded to The Tribune’s request for comment by questioning The Tribune’s reporting on the new contract.
“It is unfortunate — but not surprising — that the Tribune would once again work to create distrust around the state’s COVID response, just as they did with testing and vaccination. They choose not to be part of the solution to help ensure Utahns have the access to the care we all need to live safely with COVID,” the statement said.
Nomi is currently fighting a lawsuit in Nebraska filed on behalf of Tribune Board Chair Paul Huntsman seeking an unredacted copy of the company’s test results. Nomi claims the report should remain out of the public view because its disclosure would reveal trade secrets.
— Andrew Becker contributed to this report