Prescriptions for ivermectin, hydroxychloroquine skyrocketed during the COVID-19 pandemic

Author(s):

Austin Littrell

Key Takeaways

Hydroxychloroquine and ivermectin prescriptions surged during COVID-19, peaking in 2020 and 2021, despite evidence refuting their efficacy.
Prescription rates dropped by 93% after FDA-approved COVID-19 treatments became available, yet some prescriptions persisted.
Significant demographic disparities were observed, with higher prescription rates among older adults and in the southern U.S.
The study highlights the need for policy reforms to address misinformation and promote evidence-based care, emphasizing transparency and public trust initiatives.

UCLA research highlights the widespread use of non-evidence-based treatments during the COVID-19 pandemic, raising concerns about the role of misinformation and health care spending.

Prescription rates for hydroxychloroquine and ivermectin surged to unprecedented levels during the COVID-19 pandemic, despite substantial evidence refuting their efficacy, according to a new study out of the University of California Los Angeles (UCLA) Health Sciences.

The study, published in the peer-reviewed journal Health Affairs, analyzed insurance claims data listed in the Milliman MedInsight Emerging Experience Research Database, covering 8.1 million patients across all 50 states. Researchers found that nearly three million outpatient prescriptions were written for the two drugs from January 2020 to June 2023 — totaling approximately $272 million in spending.

Findings revealed that hydroxychloroquine prescriptions peaked in March 2020 at 133% above pre-pandemic levels, while ivermectin prescriptions surged throughout 2020 and 2021, peaking in August 2021 at more than 10 times pre-pandemic rates.

When U.S. Food and Drug Administration (FDA)-authorized COVID-19 treatments like Paxlovid became available, ivermectin and hydroxychloroquine use dropped by 93% in outpatient settings — although prescriptions did persist. Of the $272 million spent for COVID-19-related hydroxychloroquine and ivermectin, approximately $18 million was spent after the FDA-authorized COVID-19 medications became available in March 2022.

The study also noted significant demographic disparities, with combined prescription rates for both drugs three times higher among adults aged 65 and older. Ivermectin prescriptions were particularly concentrated in the southern U.S. and among socially vulnerable populations.

The persistence of these prescriptions, researchers suggest, underscores the influence of misinformation and growing distrust in scientific institutions. The study also highlights that limited availability of FDA-authorized COVID-19 medications does not appear to explain the wide geographic variation in ivermectin prescriptions, particularly in the South.

“Our findings underscore the urgent need for policy reforms to combat misinformation and mistrust in scientific institutions,” said John N. Mafi, MD, MPH, senior author of the study and associate professor-in-residence in the UCLA Division of General Internal Medicine and Health Services Research. “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.”

The study’s lead author, Michelle Rockwell, PhD, RD, of Virginia Tech Carilion School of Medicine, emphasized the broader implications of these prescribing patterns. “This utilization represents wasteful spending and potentially avoidable harm,” Rockwell said. “Our findings highlight the complex drivers of non-evidence-based care, particularly in a time of uncertainty and distress. Multilevel efforts to enhance equitable, high-value care while minimizing non-evidence-based care are needed.”

The study’s findings suggest that addressing misinformation and prescribing patterns may require a combination of health care communication strategies, policy measures, and public trust initiatives.