The ongoing uncertainty over whether hydroxychloroquine can successfully treat Covid-19 appears to have eroded demand considerably among hospitals, according to new data. At the same time, anecdotal evidence suggests that patients with lupus, a condition for which the drug is approved to treat, are having an easier time filling prescriptions for the first time in weeks.

From the week ending April 17 to the week ending April 24, demand plunged 62% among hospitals placing orders for the decades-old malaria drug. The number of tablets sought fell to 198,500 from 462,850 during that stretch, according to Vizient, a group purchasing organization that negotiates contracts for medicines on behalf of about 3,000 hospitals and health care facilities in the U.S.

At the same time, supplies appear to be stabilizing, most likely due to donations from several large manufacturers — including Bayer, Teva Pharmaceutical and Novartis — that agreed to provide millions of tablets to the U.S. Strategic National Stockpile after the Food and Drug Administration issued an emergency use authorization for hospitals.

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As a result, the so-called fill rate — the rate that orders were able to filled and shipped to hospitals — is starting to bounce back. Although the rate hovered around 55% mid-month and then fell to 32% several days later, it now stands at 45%, according to Dan Kistner, group senior vice president for pharmacy solutions at Vizient. He also expects the fill rates to stabilize and improve over time.

The shift comes amid controversy over the extent to which hydroxychloroquine can help Covid-19 patients. The drug, which is approved to treat lupus and rheumatoid arthritis, as well as malaria, had been widely touted a few weeks ago by President Trump, helping to spark a binge of prescription writing and hospital orders that created severe shortages.

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The rush occurred even as evidence was lacking that hydroxychloroquine — and a related drug called chloroquine — might be effective in thwarting the novel coronavirus. The picture was further muddied by a growing number of small studies – especially from France and China – that offered tantalizing suggestions of efficacy, but widely criticized for being poorly designed.

Consequently, a growing number of physicians and public health experts cautioned that the tablet should not be embraced as a salve until more data is obtained from several trials under way. Toward that end, the FDA last week issued a cautionary note to health care providers because the drug may cause irregular heart rhythms, especially when used in combination with the azithromycin antibiotic.

Nonetheless, shortages persisted due to supply constraints faced by the companies – mostly in China and India – that supply the active pharmaceutical ingredient for the drug. The problem spread to compound pharmacies as well, after one U.S. supplier boosted wholesale prices for the ingredient after it became harder to obtain raw materials from its own overseas sources.

Meanwhile, lupus and rheumatoid arthritis patients have become collateral damage. For weeks, many were unable to obtain their usual prescriptions, causing concerns about their health. Some also were alarmed after hearing a drumbeat of warnings about side effects risks, according to Kenneth Farber, president of Lupus Research Alliance, an advocacy group that is sponsoring an observational study to assess the incidence of Covid-19 among lupus patients who are already taking hydroxychloroquine for their condition.

Over the past several days, however, he indicated that the shortage has abated most everywhere and lupus patients say they are finding it easier to obtain hydroxychloroquine. He attributed the change to increased production and reservations among some physicians to increasingly prescribe the tablet for Covid-19. But he worries hoarding may return if studies indicate the drug is useful for the coronavirus.

“One very unfortunate aspect of the whole hydroxychloroquine debate is all of the exaggeration promulgated both by the original proponents of its use for Covid-19 and by detractors of the idea of using it. Proponents exaggerated the value of the anecdotal evidence suggesting that hydroxychloroquine was a useful treatment for Covid-19 and detractors, to discourage the use of the drug, exaggerated the side-effects of hydroxychloroquine,” he wrote us.

“This unfortunate controversy had its nature in politics as much as in science. Lupus patients were the victims of the ridiculous controversy.”

  • This guy is merely a Big Pharma lobbyist who has no idea what he’s talking about. Stop this crap, and be sure to save your head in a short few weeks when the boomerang will return to hit those who have contributed to this MASSIVE mediatic intoxication.

  • “The drug, which is approved to treat lupus and rheumatoid arthritis, as well as malaria, had been widely touted a few weeks ago by President Trump, helping to spark a binge of prescription writing and hospital orders that created severe shortages.” So doctors prescribed this because they were blindly following Pres. Trump? really? It wasn’t because many (not all) people have had sudden turn-arounds in their health when this drug was used? I know. My best friend was in bad shape and this drug saved his life—despite the absence of a double-blind 5-year peer-reviewed Dr. Fauci-sanctioned study blah blah. Go figure!

  • Hi Ed,
    I am a Pharmacist in Mysore,a little city in distant India.
    I have four retail pharmacies in Mysore,two running 24×7
    I have 102 employees and we all were really concerned how to reduce the risk of Covid 19 exposure.
    With the current knowledge,we decided to take Hydroxychloroquine 400mg once a week on full stomach.We also started taking Vitamin C 500mg and Vitamin D3 2000 I U every day.
    We have completed six weeks and all of us are doing fine.
    We are of course,wearing masks and all of us take Hot water shower after going home.

    • Hi Raghavan,

      Thanks for the note.
      I don’t know what to make of your experience, though.
      But I’m glad you’re all safe.

      ed at pharmalot

  • Hi sir,Hydroxycholroqiun is used to cure COVID-19 and Spanish flu was spread over in 1920 and it affected mahatma gandhi and it was cured why the flu medicine can be used to cure COVID-19.

  • Hydroxychloroquine is being used off-label all over the country for Covid-19. This is why the number of hospitalizations never got to their expected rate. We can all go back to work.

    • Exactly ! That’s why these people try to mislead the naïve and the ignorant. HCQ + Azithro is a drug that has to be administered as soon as the first symptoms start, thus drastically reducing the number of hospitalizations.
      But it will take still more decisive information to finally and definitely ridicule all the Big Pharma people who are trying to dismiss this treatment to push the Remdesivirn which was abandoned in Europe, as proven inefficient and nocive.

  • I work in a Veterans Hospital as Respiratory Therapist and I have seen this used several times I cant believe people hate Trump so much they would rather people die then this be helpful in any way.

  • The results from observational trials has shown weeks ago that late treatment is not recommended. However, early treatment is recommended. But you can’t find many trials on early intervention???

  • My guestimate is that Hydroxychloroquinein combination with azithromycin and Zinc will turn out to be somewhat effective if give early in the disease .I further will guess that it is likely of no benefit if administered later and may be especially harmful if started when the patients are placed on a ventilator. I suspect it may decrease the inflammation and possibly ameliorate the immune response that seem to accompany this illness. The assertions of
    MSM cardiologists about the dangers of his drug were disgraceful and completely inconsistent with the side effects in lupus and RA patients who have taken this drug for years.

  • Does anyone really believe that doctors and hospitals started buying/prescribing hydroxychloroquine just because Trump was excited about its potential as a treatment for COVID?

    Even if he flat-out said he thinks it’s the next cure for the pandemic, would medical professionals buy it?

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