US outpatient prescriptions for hydroxychloroquine and ivermectin, two unproven treatments touted as COVID-19 treatments during the pandemic, doubled and increased by 10-fold, respectively, from January 30, 2020, to June 30, 2023, according to a new study in Health Affairs.
The 3 million prescriptions for the drugs resulted in $272 million estimated spending, and older adults were more likely to take these treatments, the study authors said.
'Urgent need for policy reforms'
"Our findings underscore the urgent need for policy reforms to combat misinformation and mistrust in scientific institutions," said John Mafi, MD, MPH, the senior study author, in a press release from the University of California Los Angeles. "Eliminating undue industry influence in government, enhancing transparency around scientific uncertainty, and earmarking public funding for clinical trials of new drugs are good places to start."
Our findings underscore the urgent need for policy reforms to combat misinformation and mistrust in scientific institutions.
Mafi and his colleagues looked at insurance claims listed in the Milliman MedInsight Emerging Experience Research Database for 8.1 million insured patients from across the country to assess the use and spending for the two medications during the first 3 years of the pandemic.
During the study period, this cohort used 1,369,281 total prescriptions for hydroxychloroquine and ivermectin in outpatient settings, the authors said. Of these, 90,141 were in excess of 2019 prescribing rates and were categorized as COVID-19–associated.
"When this number is extrapolated to the US population of insured adults, an estimated 3,037,751 COVID-19-associated prescriptions for hydroxychloroquine and ivermectin totaling an estimated $271,559,207 in spending were provided in US outpatient settings throughout the public health emergency," the authors wrote.
Use highest in older adults
Patients ages 65 and older represented 25% of adults included in the study but were responsible for 68% of COVID-19-associated hydroxychloroquine use and 59% of COVID-19-associated ivermectin use.
Hydroxychloroquine use peaked in March 2020 to 133% of pre-pandemic rates, likely after President Donald Trump touted the drug as a cure for the virus. Before COVID, the drug was traditionally used as an anti-malarial.
Prescriptions for ivermectin peaked in August 2021, 10 times higher than pre-pandemic rates. Ivermectin is also an anti-parasite treatment. Hydroxychloroquine use was evenly distributed across the United States, but outpatient use of ivermectin was significantly higher in southern states (366% of expected rates).
The authors said the study shows the widespread use of medications that were largely touted via misinformation, and were prescribed even after early studies disproved them as effective COVID-19 treatments.
"The results of this study highlight the need for targeted efforts to mitigate the use of non-evidence-based, potentially harmful care to improve health outcomes and promote health equity during national emergencies," the authors concluded.
