Researchers from Brigham and Women’s Hospital examined significant changes in prescription patterns in the United States during the coronavirus pandemic.
The researchers, who published their findings in JAMA, found that prescriptions of the old anti-malarial drugs chloroquine and hydroxychloroquine dramatically surged in mid-March, likely due to off-label prescriptions for COVID-19.
Dr. Haider Warraich of Brigham and Women’s Hospital said, “There have been indications that hydroxychloroquine prescribing had increased and shortages had been reported, but this study puts a spotlight on the extent to which excess hydroxychloroquine/chloroquine prescriptions were filled nationally.”
“This analysis doesn’t include patients who were prescribed HCQ in a hospital setting,” he added, “this means that patients could have been taking the drugs at home, without supervision or monitoring for side effects.”
Chloroquine and hydroxychloroquine are prescribed to treat and prevent malaria; however, the latter is also advised to treat autoimmune diseases such as lupus and rheumatoid arthritis.
Experts have suggested that the drugs may have antiviral effects, and are relatively cheaper, which is why they are of much interest in their potential efficacy in treating COVID-19.
However, some studies have found that chloroquine and hydroxychloroquine did not show an improvement in survival and mortality rates; instead, they increased the risk of cardiovascular events.
Dr. Warraich and colleagues looked at prescribing patterns for chloroquine/hydroxychloroquine as well as many other commonly prescribed drugs, such as azithromycin (antibiotic), and angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), which are anti-hypertensive agents.
The researchers compared the number of prescriptions filled for each drug to the number of prescriptions filled last year from February 16 to April 25.
During the study period, chloroquine/hydroxychloroquine prescriptions increased from 2,208 prescriptions in 2019 to 45,858 prescriptions in 2020.
In contrast, prescriptions for azithromycin declined and prescriptions for heart drugs remained stable or declined slightly.
With the surge in chloroquine and hydroxychloroquine prescriptions, the Food and Drug Administration (FDA) reported a drug shortage of hydroxychloroquine since March 31.
“During this pandemic, there has been both good information and misinformation about benefits and potential harms of common medications like hydroxychloroquine, and there had been conjecture that proven medications for heart failure may be harmful in this patient population,” Dr. Warraich said. “One positive finding is that we didn’t see a stark reduction in prescription fills for routine, chronic care, but our findings for HCQ are concerning,” he added.
