Washington state health officials have directed pharmacists to use their discretion in filling prescriptions for drugs that President Donald Trump called “game changers” in slowing the spread of the coronavirus.
There has been a shortage of these drugs across Washington and the country.
“The pharmacy is the gatekeeper,” said Lauren Lyles-Stolz, executive director of the Pharmacy Quality Assurance Commission, Lauren Lyles-Stolz. “We know that we need to be proactive.”
These drugs, hydroxychloroquine (or Plaquenil), chloroquine, and azithromycin, are not yet FDA-approved for COVID-19. The medications are used to treat lupus, rheumatoid arthritis and malaria.
Two state Department of Health boards, the Washington Medical Commission and the Pharmacy Quality Assurance Commission, have released statements advising pharmacists to question prescriptions for these drugs.
“If it doesn’t look like it’s for the diagnosis and it doesn’t seem right, they can use that professional judgment to say we need more info or we don’t feel comfortable filling this,” Lyles-Stolz said.
The Washington Medical Commission said there is only one producer for some of these drugs, which were already on the drug shortage list. A surge of these prescriptions will hurt lupus patients and others, spokesperson Stephanie Mason said.
“The FDA has not said this is an effective treatment for COVID-19, but people have been misinformed that it can be a treatment and maybe not appropriate and depleting the supply chain,” Mason said.
Lyles-Stolz said doctors have begun prescribing themselves and family members the drugs.
In a similar statement from the Washington Medical Commission, the board condemned inappropriate prescribing. Commissioners pointed to an existing policy that takes a position against self-treatment and prescribing for family members.
Pharmacy companies have begun to implement their own restrictive policies due to supply shortages.
Prescribing and administration of these investigational medications for COVID-19 are considered “off-label,” or using a drug for an unapproved reason, Walgreens said in a statement.
“To help ensure these medicines remain available for those who need it, Walgreens has issued guidelines to our pharmacies on any new prescription for chloroquine or hydroxychloroquine for patients who do not have a prior history of use,” the company said.
Walgreens has placed a 14-day supply limit for new prescriptions, a 30-day supply for refills or prescriptions with a prior history of use, and all active 90-day prescriptions are limited to 30 days.
A CVS spokesperson, Mike DeAngelis, said pharmacies will follow any state-dispensing guidelines, but if there are none, the company is limiting prescriptions for “COVID-19” treatment to 10-supply with no refills.
National experts have responded to Trump’s claims.
“I am saying it may be effective,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters last week.
The state Department of Health’s Pharmacy Quality Assurance Commission said that while the drugs can ease symptoms of the virus, they aren’t clinically approved.
“We understand research is currently underway with hydroxychloroquine and azithromycin and acknowledge that these drugs may be helpful at certain stages of the disease,” the commission said in a statement.
The University of Washington has begun doing tests on the drugs as a “very promising” treatment but warns the drugs have not gone through clinical trials, one professor told GeekWire.