Sun. Sep 25th, 2022
Doctors hoard unproven COVID-19 drugs by writing prescriptions for themselves, families

A nationwide shortage of two drugs touted as possible treatments for the coronavirus is caused in part by doctors inappropriately prescribing the drugs to family, friends and themselves, according to pharmacists and state regulators.

“It’s a shame, it is what it is,” said Garth Reynolds, executive director of the Illinois Pharmacists Association, who received calls and emails Saturday from members saying they were receiving questionable prescriptions. “And completely selfish.”

Demand for chloroquine and hydroxychloroquine has soared in recent days as President Donald Trump promoted them as possible treatments for the coronavirus and online forums have been abuzz with excitement over a small study suggesting the combination of hydroxychloroquine and a commonly used antibiotic could be effective in treating of COVID-19.

Reynolds said the Illinois Pharmacists Association has begun reaching out to pharmacists and medical groups across the state to urge doctors, nurses and physician assistants not to write prescriptions for themselves and their loved ones.

“We even had a few examples of prescribers trying to say that the person they were calling for had rheumatoid arthritis,” he said, explaining that pharmacists suspected that wasn’t true. “I mean, that’s fraud.”

In one case, Reynolds said, the prescriber initially tried to get the pills without explanation and only offered that the person had rheumatoid arthritis after the pharmacist questioned the prescription.

In a bulletin to pharmacists on Sunday, the state association wrote that it was “concerned by the current actions of prescribers” and instructed members on how to file a complaint against doctors and nurses who did so.

“People are losing their minds about this product,” said Brian Brito, president of SMP Pharmacy Solutions in Miami. “We sell so much of this stuff and people just store it prophylactically if someone in their family gets sick — they just hold onto it.”

The two drugs are prescription only and cannot be bought without a prescription. Hydroxychloroquine, sold under the brand name Plaquenil, is approved to treat lupus and rheumatoid arthritis, while chloroquine is an antimalarial treatment.

Who needs proof?

There is little evidence that the drugs work to treat the coronavirus, although clinical trials are underway to find out. But as the number of coronavirus cases mounts and protective equipment for medical personnel disappears from emergency rooms, many patients and doctors see the drugs as the only hope of reversing the course of a serious illness.

Brito said his pharmacy had about 800 tablets on Monday and nearly sold out in about an hour. A doctor called and asked for 200 tablets, but the company refused. “He was a little upset about it, but he understood and he quickly went from 200 to 42 tablets, which is essentially treating two people,” Brito said. “So yeah, they’re hitting it.”

A Houston pharmacist, who wished to remain anonymous for fear of retaliation and invasion of patient privacy, said he was recently asked by a surgeon for an unusually large quantity with unlimited refills. “He said it was because his wife had lupus,” the pharmacist said, “but when I asked him for her name and diagnosis, he told me to just put it in his.”

Lupus patients report problems refilling their prescriptions for the drug. On Monday, the Lupus Foundation of America issued a joint statement asking the White House’s Coronavirus Task Force to “take action to ensure current supplies are allocated to patients using them for indicated use.” Several states have already taken steps in recent days to limit prescriptions for the drugs, neither of which has been approved to treat the coronavirus. Trump has promoted the use of the drugs in press conferences and tweets over the past week as a possible mitigation of the impact of the COVID-19 outbreak.

“It’s unfortunate that at a press conference, I think premature, it seemed like this was the answer, and that’s what led to this panic,” Michelle Petri, director of the Lupus Center at Johns Hopkins University School of Medicine, said Friday. “I’ve spent the past two days trying to help lupus patients who really need their fillings.” She said some patients have refills on back order, while others are getting smaller amounts than usual.

borders

The West Virginia Board of Pharmacy on Saturday issued a warning to pharmacists to limit new prescriptions to no more than 30 tablets and only to cases where the drugs were used for approved indications.

“Currently, both nationally and in West Virginia, some prescribers have begun to write prescriptions for these drugs for family, friends and colleagues in anticipation of COVID-19-related illness,” the board wrote.

Texas and Ohio have also restricted the prescription of the drugs. Louisiana also issued an emergency rule Sunday limiting when the drugs can be prescribed, citing “inappropriate use” and “hoarding.” On Monday, the Louisiana Board of Pharmacy said it was withdrawing that order because manufacturers had ramped up distribution of the drugs.

Experts warn that any use of the drugs outside of a hospital setting could be dangerous, and urge doctors to stop prescribing the drugs inappropriately.

Daniel Brooks, the medical director of the Banner Poison and Drug Information Center in Phoenix, said it was “immoral” for doctors to hoard the drugs.

“You shouldn’t be selfish and scared, especially not medical providers,” he said. “I find it incredibly embarrassing and unfortunate that doctors seem to be prescribing these drugs inappropriately.”

This weekend, Brooks cared for a man in his 60s who died after ingesting a version of chloroquine commonly used to clean aquariums. The man, who thought he might have COVID-19, took a small amount of the substance in a misguided attempt to treat his symptoms. His wife was also hospitalized after ingesting the substance, but survived.

Brooks said the amount the couple took was equivalent to a few days of prescribed chloroquine.

“A double blow”

Ken Thai, the owner of a chain of pharmacies in Los Angeles, said his stores are witnessing a wave of inappropriate prescribing.

“Unfortunately, many doctors write high amounts for more than the required number of tablets and call five, six, seven and eight prescriptions at a time,” he said. “I don’t want to insinuate what’s going on, but it’s very unusual.”

He said his pharmacists are refusing to fill suspicious orders and are telling prescribers they don’t have enough drugs on hand to fulfill those requests. Among the prescriptions are those for people who have not taken the drug before, as well as orders from doctors who do not typically treat lupus and rheumatoid arthritis patients.

“When a doctor writes a prescription for themselves or aunts and uncles, that’s usually a red flag for us,” he said. “Whatever we have in stock, we have to keep it for the patients we currently serve.”

Pharmacists exchanged stories on Twitter about dentists and ophthalmologists asking for hydroxychloroquine under dubious pretenses. “A dentist just tried to invoke hydroxychloroquine + azithromycin scripts for himself, his wife and another couple (friends),” tweeted a pharmacist in Eugene, Oregon. “I have patients with lupus who have had HCQ [Hydroxychloroquine] for YEARS and can’t get it now because it’s on backorder.”

Steve Moore, president of the New York State Pharmacists Society, said medical providers hoarding the drugs are in the state, which has the highest number of coronavirus cases in the country.

“That’s a double whammy,” he said. “We may be taking that medication away from patients with autoimmune diseases and patients with the actual virus that may need to be treated.”

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By akfire1

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