Trump-fueled promotion of unproved coronavirus drug generated spike in prescriptions, study finds

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Patients who need chloroquine for treatment of other illnesses may be cut off

Publicity about a small study of a potential covid-19 treatment was enough to create a 200 percent increase in hydroxychloroquine and chloroquine prescriptions in March. Although the biggest surge was short-lived, almost a half million extra prescriptions were filled over a 10-week period studied by researchers, according to the results published yesterday in the Journal of the American Medical Association.

The national study found that hydroxychloroquine/chloroquine prescriptions were increasing slowly when the pandemic was declared, but shot up after publicity about a non-randomized study of 19 Chinese patients on March 17. Although that study has been widely criticized, Fox News personalities and President Trump promoted the potential cure.

Increase in hydroxychloroquine and

chloroquine prescriptions

A study in the Journal of the American Medical Association measured the increase in hydroxychloroquine and chloroquine prescriptions as the coronavirus pandemic grew in the United States and President Trump joined in promoting the drug as a cure for covid-19.

200%

Percent change

from weekly

prescriptions

in 2019

100

29

14

21

28

11

18

25

March 12

The WHO declares the coronavirus a pandemic. The next day, the U.S. declares a state of emergency.

March 17

A Chinese study touting the effectiveness of the drug is released and widely promoted on Fox News and by President Trump. Three days later, Trump embraces the drug at a press conference.

March 28

The FDA issues EUA to allow hydroxychloroquine and chloroquine used for certain hospitalized patients. Three days later, shortages of the drug are reported.

April 24

FDA cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of hospitals.

Increase in hydroxychloroquine and

chloroquine prescriptions

A study in the Journal of the American Medical Association measured the increase in hydroxychloroquine and chloroquine prescriptions as the coronavirus pandemic grew in the United States and President Trump joined in promoting the drug as a cure for covid-19.

200%

Percent change

from weekly

prescriptions

in 2019

100

March 12

The WHO declares the coronavirus a pandemic. The next day, the U.S. declares a state of emergency.

March 17

A Chinese study touting the effectiveness of the drug is released and widely promoted on Fox News and by President Trump. Three days later, Trump embraces the drug at a press conference.

March 28

The FDA issues EUA to allow hydroxychloroquine and chloroquine used for certain hospitalized patients. Three days later, shortages of the drug are reported.

April 24

FDA cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of hospitals.

Increase in hydroxychloroquine and chloroquine prescriptions

A study in the Journal of the American Medical Association measured the increase in hydroxychloroquine and chloroquine prescriptions as the coronavirus pandemic grew in the United States and President Trump joined in promoting the drug as a cure for covid-19.

200%

Percent change

from weekly

prescriptions

in 2019

100

March 12

The WHO declares the coronavirus a pandemic. The next day, the U.S. declares a state of emergency.

March 17

A Chinese study touting the effectiveness of the drug is released and widely promoted on Fox News and by President Trump. Three days later, Trump embraces the drug at a press conference.

March 28

The FDA issues EUA to allow hydroxychloroquine and chloroquine used for certain hospitalized patients. Three days later, shortages of the drug are reported.

April 24

FDA cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of hospitals.

Increase in hydroxychloroquine and chloroquine prescriptions

A study in the Journal of the American Medical Association measured the increase in hydroxychloroquine and chloroquine prescriptions as the coronavirus pandemic grew in the United States and President Trump joined in promoting the drug as a cure for covid-19.

200%

Percent change

from weekly

prescriptions

in 2019

100

Week of Feb. 22

Feb. 29

March 7

March 14

March 21

March 28

April 4

April 11

April 18

April 25

March 12

The WHO declares the coronavirus a pandemic. The next day, the U.S. declares a state of emergency.

March 17

A Chinese study touting the effectiveness of the drug is released and widely promoted on Fox News and by President Trump. Three days later, Trump embraces the drug at a press conference.

March 28

The FDA issues EUA to allow hydroxychloroquine and chloroquine used for certain hospitalized patients. Three days later, shortages of the drug are reported.

April 24

FDA cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of hospitals.

Increase in hydroxychloroquine and chloroquine prescriptions

A study in the Journal of the American Medical Association measured the increase in hydroxychloroquine and chloroquine prescriptions as the coronavirus pandemic grew in the United States and President Trump joined in promoting the drug as a cure for covid-19.

200%

Percent change

from weekly

prescriptions

in 2019

100

Week of Feb. 22

Feb. 29

March 7

March 14

March 21

March 28

April 4

April 11

April 18

April 25

March 12

The WHO declares the coronavirus a pandemic. The next day, the U.S. declares a state of emergency.

March 17

A Chinese study touting the effectiveness of the drug is released and widely promoted on Fox News and by President Trump. Three days later, Trump embraces the drug at a press conference.

March 28

The FDA issues EUA to allow hydroxychloroquine and chloroquine used for certain hospitalized patients. Three days later, shortages of the drug are reported.

April 24

FDA cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of hospitals.

The week before the publicity, prescriptions were 31 percent higher than normal, but over the next week, the prescriptions shot up 214 percent above normal, said the researchers from Brigham and Women’s Hospital in Boston, the Boston Veteran’s Administration Healthcare System and GoodRx.

The number of short-term prescriptions went up far higher — from 2,208 prescriptions in a week last year to 45,858 this year — an increase of almost 2,000 percent. The increase in short-term prescriptions (up to 28 tablets) continued for the entire 10-week study, still up more than 800 percent near the end of April.

But the prescriptions for more than 60 tablets had dropped by two-thirds from the year before, a very dangerous sign that patients who need the drugs for treatment of lupus or rheumatoid arthritis were struggling to get their normal medicine due to reported shortages of the drug.

The study found that the most popular high blood pressure medicines, losartan, amlodopine and lisinopril, remained relatively steady over the 10-week period despite concerns that they may increase susceptibility to covid-19. High blood pressure is considered a risk factor for covid-19, but the drugs that treat it may contribute to that danger, so the researchers had expected the prescription rates to drop.

While most drug demand was down,

prescriptions incresead for

hydroxychloroquine and

chloroquine during quarantine

Percent change from weekly prescriptions in 2019

Hydroxychloroquine

Chloroquine

200%

100

-100

Feb. 22

March 21

April 25

Losartan

200%

100

-100

Feb. 22

March 21

April 25

Hydrocodone-

Acetaminophen

200%

100

-100

Feb. 22

March 21

April 25

Lisinopril

200%

100

-100

April 25

Feb. 22

March 21

Azithromycin

200%

100

-100

March 21

April 25

Feb. 22

Amoxicillin

200%

100

-100

Feb. 22

March 21

April 25

While most drug demand was down,

prescriptions incresead for

hydroxychloroquine and chloroquine

during quarantine

Percent change from weekly prescriptions in 2019

Hydroxychloroquine

Chloroquine

Losartan

200%

100

-100

Feb. 22

April 25

Feb. 22

April 25

Hydrocodone-

Acetaminophen

Lisinopril

200%

100

-100

Feb. 22

April 25

Feb. 22

April 25

Azithromycin

Amoxicillin

200%

100

-100

Feb. 22

April 25

Feb. 22

April 25

While most drug demand was down, prescriptions incresead for

hydroxychloroquine and chloroquine during quarantine

Percent change from weekly prescriptions in 2019

Hydroxychloroquine

Chloroquine

Losartan

200%

100

-100

April 25

March 21

April 25

Feb. 22

March 21

Feb. 22

Hydrocodone-

Acetaminophen

Lisinopril

200%

100

-100

Feb. 22

March 21

April 25

Feb. 22

March 21

April 25

Azithromycin

Amoxicillin

200%

100

-100

Feb. 22

March 21

April 25

Feb. 22

March 21

April 25

While most drug demand was down, prescriptions incresead for

hydroxychloroquine and chloroquine during quarantine

Percent change from weekly prescriptions in 2019

Hydroxychloroquine

Chloroquine

Losartan

Lisinopril

200%

100

-100

Feb. 22

March 21

April 25

Feb. 22

March 21

April 25

Feb. 22

March 21

April 25

Hydrocodone-

Acetaminophen

Azithromycin

Amoxicillin

200%

100

-100

Feb. 22

March 21

April 25

Feb. 22

March 21

April 25

Feb. 22

March 21

April 25

Another unexpected finding was the lack of a spike in prescriptions for azithromycin, which can treat bacterial infections and was used in early studies along with hydroxychloroquine to treat covid-19. Although it was mentioned along with the other drugs, azithromycin did not attract as much attention and prescriptions for the drug fell rather than spiking.

Some of the most common prescriptions also decreased this year compared with last year, the study found, including amoxicillin for routine infections and atorvastatin to lower cholesterol. They were both down almost two-thirds. Researchers said decreases may be due to patients losing insurance when they lose jobs or patients being unable to see doctors to get prescriptions during the pandemic.

The study was done with data from 58,332 store and mail-order pharmacies and then adjusted for national rates.

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