U.S. Hydroxychloroquine Prescriptions Spiked by 86 Percent in March

Prescriptions of the antimalarial drugs chloroquine and hydroxychloroquine rose in every U.S. state and Washington D.C. after they were touted as a potential COVID-19 treatments earlier this year, according to a study. Among the findings were that prescriptions of both hydroxychloroquine and azithromycin, an antibiotic it is sometimes combined with, rose by 1044 percent between February and March.

In March, the hype around hydroxychloroquine and its close relative chloroquine built after a pre-print study on the drug—later found to have a number of flaws—claimed the former helped clear patients of the virus, and the effects were reinforced by azithromycin.

President Donald Trump later tweeted hydroxychloroquine and azithromycin "taken together, have a real chance to be one of the biggest game changers in the history of medicine." This was followed by the U.S. Food and Drug Administration issuing an emergency use authorization for the drugs, before warning it should only be used in a hospital setting as it had the potential to cause "serious and potentially life-threatening heart rhythm problems." Clinical trails have since failed to show it has any clear benefit for COVID-19 patients.

For their study published in the journal JAMA Internal Medicine researchers with the U.S. Centers for Disease Control and Prevention (CDC) COVID-19 Response Team looked at a database on initial prescriptions and refills form 48,000 retail pharmacies in the U.S., accounting for 92 percent of retail prescriptions. The team removed duplicates from the data, and estimated the number of patients who had prescriptions nationally.

Between October 2019 and February 2020, an average of 383,685 people were being prescribed hydroxychloroquine and chloroquine. From February 2020 to March 2020, the estimated number of patients receiving chloroquine increased by 158 percent from 2,346 to 6,066. For hydroxychloroquine, prescriptions increased by 86.2 percent, from 367,346 to 683,999. Among patients having both hydroxychloroquine and azithromycin, the figure rose by 1044 percent, from 8,885 to 101,681.

Estimated prescriptions of the malaria drugs increased in all states and Washington D.C.. The biggest spikes were seen in New Jersey, Florida, Hawaii, and New York, with the lowest in South Dakota and Iowa.

The researchers said it was "notable" that in one month, approximately 300,000 more patients than usual were given hydroxychloroquine.

The team said it is not clear that every new prescription noted in their study was for COVID-19, and it is unclear if patients used the drugs immediately or saved them. The data was gathered before the release of many treatment guidelines and while state regulations were evolving, they said.

Andrew Preston, who researches microbial pathogenesis at the U.K.'s University of Bath and did not work on the paper, told Newsweek via email: "The study confirms what had been described anecdotally many times: hydroxychloroquine was being used as a treatment for COVID-19 during March."

Preston said the study highlights the need to get the balance right between making reports and studies publicly available as fast as possible in emergency situations like the COVID-19 pandemic, and making sure they are robust. It also reiterates the value of controlled trials of treatments, he said.

"This places clinicians in difficult situations: facing large numbers of very sick patients with no validated therapeutics available, but tantalizing snippets of data suggesting some drugs might work," he said. "It was a credit to those involved that the large trials that properly tested the efficacy of hydroxychloroquine were established so quickly, and able to report in what is a very short time frame.

"Although disappointing to find that such a readily available drug such as hydroxychloroquine does not work [against COVID-19], it does allow resources to be focused on other targets, and of course, in this case prevent further patients being treated with a drug that can cause serious side effects."

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A pharmacy tech holds a pill of hydroxychloroquine at Rock Canyon Pharmacy in Provo, Utah, on May 20, 2020. GEORGE FREY/AFP via Getty Images