Surge in Ivermectin and Hydroxychloroquine Prescriptions During COVID-19 Pandemic

U.S. outpatient prescriptions for ivermectin and hydroxychloroquine saw dramatic increases during the COVID-19 pandemic, reaching levels 2 to 10 times higher than those prior to the pandemic, according to recent research from the University of California, Los Angeles (UCLA). Despite substantial evidence indicating their ineffectiveness against the virus, nearly three million prescriptions related to COVID-19 were issued from January 30, 2020, through June 30, 2023, amounting to an estimated expenditure of $272 million.

The study highlighted that usage of these medications was particularly prevalent among older adults aged 65 and above, who were three times more likely to receive prescriptions compared to younger adults aged 18 to 64. Additionally, the data revealed that ivermectin prescriptions were notably higher in socially vulnerable neighborhoods and significantly concentrated in the Southern United States.

Published in the journal Health Affairs, the findings emphasize the need for policy reforms aimed at addressing misinformation surrounding COVID-19 treatments, particularly in marginalized communities. The researchers utilized insurance claims data from the Milliman MedInsight Emerging Experience Research Database, encompassing 8.1 million patients nationwide, to evaluate the spending and utilization of these medications during the pandemic.

Some key findings from the research include:

• Close to three million COVID-related prescriptions were recorded in outpatient settings, resulting in a total expenditure of $272 million.
• Hydroxychloroquine prescriptions peaked in March 2020, reaching 133% of pre-pandemic levels.
• Ivermectin usage surged significantly in 2020 and throughout 2021, peaking in August 2021 at more than ten times the pre-pandemic rate.
• After the introduction of FDA-authorized COVID-19 treatments, such as Paxlovid, there was a dramatic decline of 93% in outpatient prescriptions for both ivermectin and hydroxychloroquine from March 1, 2022, to June 30, 2023.
• Of the estimated $272 million spent on these medications, around $18 million was expended after March 2022, when FDA-authorized treatments became accessible.
• The geographic variance in ivermectin prescriptions could not be solely attributed to the availability of COVID-19 medications, particularly in the Southern states.

Despite the significant findings, the study does come with limitations. The cohort used a convenience sample, meaning that the data was drawn from a readily available group rather than a randomly selected population. While this could impact the generalizability of the findings, previous studies have confirmed that the demographics of the dataset reflect the overall U.S. population. Moreover, the study did not account for medications obtained without prescriptions or insurance, which may have led to variations in price and spending estimates.

This research represents the first comprehensive analysis of trends in the utilization and spending of ivermectin and hydroxychloroquine in U.S. outpatient settings throughout the COVID-19 pandemic. The findings point to potential wasteful spending and highlight the risks associated with non-evidence-based care during a public health crisis. The authors suggest that multi-level strategies are necessary to promote equitable, high-quality healthcare while minimizing reliance on ineffective treatments.