Prescriptions for Hydroxychloroquine, Chloroquine Soared Earlier in Pandemic

Have pharmacists been filling more prescriptions recently for hydroxychloroquine and chloroquine, or the two together? A new study says the answer isn’t just yet – it is a thousand times yes. Find out about dramatic increases in prescribing for the drugs which have been touted as potential treatment for COVID-19.

ATLANTA – If pharmacists suspect they have filled a lot more hydroxychloroquine, chloroquine, and azithromycin prescriptions than usual in recent month, they are correct. In fact, the increases in prescription for both together exceeds 1000%.

A report in JAMA Internal Medicine advises that, from February 2020 to March 2020, the estimated number of patients receiving dispensed hydroxychloroquine prescriptions increased 86.2% -- from 367, --346 to 683 999) and the number receiving dispensed chloroquine prescriptions increased 158.6% -- from 2,346 to 6,066.

In fact, authors from the national Centers for Disease Control and Prevention report that, of the patients receiving dispensed hydroxychloroquine prescriptions, the estimated number receiving both hydroxychloroquine and azithromycin increased 1044% -- from 88,85 to 101,681.

The article points out that hydroxychloroquine and chloroquine are oral antimalarial drugs under investigation for prophylaxis and treatment of coronavirus disease 2019 (COVID-19), adding that additional benefit of using these drugs with azithromycin has been reported but not confirmed.

“Recently, Internet searches for purchasing hydroxychloroquine and chloroquine increased dramatically, and instances of increased prescribing and commercial purchasing have been reported,” the authors explain. As a result, they sought to quantify changes in outpatient prescriptions of hydroxychloroquine, chloroquine, and azithromycin.

To do that, the study team used data from the IQVIA Total Patient Tracker (TPT), which collects initial prescriptions and refills paid for by commercial third parties, Medicaid, Medicare Part D, or cash and dispensed from 48, 900 US retail pharmacies; that include 3.5 billion transactions and annually covers 92% of retail prescription.

Monthly hydroxychloroquine and chloroquine dispensing between October 1, 2019, and March 31, 2020 was identified for unique patients receiving prescriptions.

The CDC researchers note that estimated numbers of patients receiving dispensed hydroxychloroquine or chloroquine increased for all states and Washington, DC, with the highest percentage increases in New Jersey, 193.8%; Florida ,156.7%; Hawaii 129.9%, and New York, 123.3%. South Dakota and Iowa have the lowest increases of 37.4% and 44.4%, respectively, according to the report.

“The notable finding is that in 1 month, approximately 300,000 additional patients received hydroxychloroquine from retail pharmacies, including an approximate additional 93,000 patients who received both hydroxychloroquine and azithromycin,” the authors write. That occurred despite limited evidence of efficacy and adverse events associated with the drugs.

One result, the researchers explain, was to limit availability for Food and Drug Administration-approved uses for rheumatoid arthritis, lupus, and malaria.

The authors say is it puzzling that “while some of the largest increases in hydroxychloroquine and chloroquine dispensing occurred in states with high COVID-19 case rates (e.g., New Jersey, New York), other states with large increases in dispensing had moderate (e.g., Florida) or low (e.g., Hawaii) case rates.”

The study cautions that the data do not include prescribing indication, so not all increased dispensing may be for COVID-19.

Furthermore, the authors write, “It is unknown if patients immediately used or saved these medications.”