The increased attention to chloroquine and hydroxychloroquine as potential treatments for COVID-19 has created “a significant flood in demand that is impacting patients,” according to Vizient.
Vizient said that, according to its research, there has been a 6,842% increase in chloroquine tablets ordered with fill rates dropping to as low as 1.4% and a 2,196% increase in hydroxychloroquine tablets ordered with fill rates dropping to as low as 12.1%, since March 16, when the WHO declared COVID-19 to be a pandemic.
As a result, Vizient is advocating the following steps to be taken by the White House Coronavirus Task Force and the Food and Drug Administration (FDA) to ensure current supplies chloroquine and hydroxychloroquine are prioritized for the patients who most need the drug and to help ensure that efficacy data can be appropriately collected.
- Retail dispensing of chloroquine and hydroxychloroquine (or other pharmaceuticals under investigation for COVID-19) should be limited to those patients who have been receiving treatment for labeled/well-established indications (e.g. lupus, rheumatoid arthritis). Strategies to address dispensing issues could include:
- Retail pharmacies and their distributors partnering to identify and return any excess inventory in the retail channel back to the distributors so they can be ordered by health systems.
- Pharmacy Benefit Managers (PBMs) and health plans requiring all new retail prescriptions for chloroquine and hydroxychloroquine to have a prior authorization to confirm it is being dispensed for approved/well-established indications or confirmed COVID-19 patients.
- State boards of pharmacy limiting prophylaxis use and imposing dispensing requirements for new retail prescriptions, specifically that the patient tested positive for COVID-19 and the length be 14 days with no refills.
- Any new suppliers coming to market or donating large inventory of products should request that the distributors prioritize that product go to health systems.
- All other distribution of hydroxychloroquine should be directed to the hospital/acute care environment where critically ill patients with COVID-19 are managed. Any information about its use in the critically ill patient population needs to be collected/aggregated to inform ongoing understanding about the safety and efficacy of these therapies.
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