Some Doctors Stockpile Trial Coronavirus Drugs for Themselves, States Say

Some Doctors Stockpile Trial Coronavirus Drugs for Themselves, States Say
A handful of state pharmacy boards have issued emergency restrictions on how the drugs can be dispensed.Credit...Ramin Rahimian for The New York Times

Doctors are hoarding medications touted as possible coronavirus treatments by writing prescriptions for themselves and family members, according to pharmacy boards in states across the country.

The stockpiling has become so worrisome in Idaho, Kentucky, Ohio, Nevada, Oklahoma, North Carolina, and Texas that the boards in those states have issued emergency restrictions or guidelines on how the drugs can be dispensed at pharmacies. More states are expected to follow suit.

“This is a real issue and it is not some product of a few isolated bad apples,” said Jay Campbell, executive director of the North Carolina Board of Pharmacy.

The medications being prescribed differ slightly from state to state, but include those lauded by President Trump at televised briefings as potential breakthrough treatments for the virus, which has killed at least 675 people in the United States and infected more than 52,000.

None of the drugs have been approved by the U.S. Food and Drug Administration for that use. Some of them — including chloroquine and hydroxychloroquine — are commonly used to treat malaria, lupus, rheumatoid arthritis and other conditions.

Pharmacists around the country have been swapping stories on social media about the spike in prescriptions written by doctors for themselves or their families.

“I have multiple prescribers calling in prescriptions for Plaquenil for themselves and their family members as a precaution. Is this ethical?” one person wrote on Sunday in a Facebook group for pharmacists, referring to a brand name of hydroxychloroquine. Others weighed in — some noting similar experiences — and expressed their hesitancy to dispense such prescriptions.

“I got called a communist for telling a prescriber, who was trying to call it in for themselves, no,” someone posted on Friday in another Facebook group for pharmacists.

Carmen Catizone, executive director of the National Association of Boards of Pharmacy, said state boards across the country were “trying to stop the hoarding and inappropriate prescribing, but balancing what patients need.” Mr. Campbell, of the North Carolina board, said medical boards and associations had to get involved as well to curb the behavior of prescribers.

The American Medical Association denounced the practice in a statement from its president, Dr. Patrice Harris.

“The A.M.A. is calling for a stop to any inappropriate prescribing and ordering of medications, including chloroquine or hydroxychloroquine, and appealing to physicians and all health care professionals to follow the highest standards of professionalism and ethics,” she said.

Dr. Harris also noted that the country’s health care professionals “continue to demonstrate remarkable leadership every day,” and can look to the organization’s code of medical ethics for guidance.

The first restrictions were imposed last week in Idaho. The board there imposed a temporary rule barring pharmacies from dispensing two drugs — chloroquine and hydroxychloroquine — unless the prescription includes a written diagnosis of a condition that the drugs have been proven to treat. The rule also limits prescriptions to a 14-day supply unless a patient has previously taken the medication.

“We wanted to try to get out in front of that as early as we could,” said Nicki Chopski, executive director of the board in Idaho, where pharmacists began reporting a significant uptick in prescriptions for the medications last week. The prescriptions, she said, were being written by doctors for themselves and their family members, often in large quantities with refills.

Texas adopted a similar rule on Friday that included another malaria drug — mefloquine — as well as the antibiotic azithromycin, commonly known by its brand name, Zithromax Z-Pak. That drug has been mentioned by Mr. Trump as another potential treatment for the coronavirus when taken in conjunction with the anti-malarial hydroxychloroquine. The effectiveness of the treatment is unproven.

Allison Benz, executive director of the Texas State Board of Pharmacy, said pharmacists were reporting an unusual increase in prescriptions for these drugs written by doctors for themselves, their family members and their office staff. As in Idaho, patients who legitimately need medications for conditions that the drugs have been proven to treat will not be restricted from getting them as a result of the new rule, Ms. Benz said.

In an emergency meeting Sunday morning reported by the Columbus Dispatch, the Ohio Board of Pharmacy barred pharmacists from dispensing the drugs to treat the coronavirus unless a person had tested positive for the virus, or the request had been approved directly by the pharmacy board’s executive director.

In a statement, CVS said that pharmacists were to use their “professional judgment to determine whether a prescription was valid and appropriate to dispense,” noting that pharmacists would comply with any applicable state board regulations.

A spokeswoman from Walgreens said its pharmacists would follow the requirements of the state where they practice, also noting that the company had issued guidelines for dispensing two of the drugs in highest demand, chloroquine and hydroxychloroquine. Walgreens will allow only a 14-day supply for new prescriptions in order to help ensure that the medications remain available for those who need them, the spokeswoman said.

Instead of instituting rules, some states are offering general guidelines for pharmacists facing the dilemma.

The Kentucky Board of Pharmacy encouraged pharmacists to “use professional judgment” in addressing whether a pharmacist should fulfill requests from physicians who are “writing prescriptions for themselves and their family members in large quantities,” according to a memo detailing Frequently Asked Questions on the board’s website.

The guidance goes on to say that the pharmacists can determine if a “valid patient-prescriber relationship exists,” while also urging the pharmacists to consider if there is enough of the drugs in stock to treat patients with rheumatoid arthritis who need it on a regular basis.

  • Updated March 24, 2020

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. The first testing in humans of an experimental vaccine began in mid-March. Such rapid development of a potential vaccine is unprecedented, but even if it is proved safe and effective, it probably will not be available for 12 to18 months.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • How do I get tested?

      If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I wear a mask?

      No. Unless you’re already infected, or caring for someone who is, a face mask is not recommended. And stockpiling them will make it harder for nurses and other workers to access the resources they need to help on the front lines.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Can I go to the park?

      Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

    • What should I do with my 401(k)?

      Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”


You May Also Like

0 Comments