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Prescription Fill Patterns for Commonly Used Drugs During the COVID-19 Pandemic in the United States

Educational Objective
To understand how COVID-19 has affected prescription fill patterns for commonly used drugs
1 Credit CME

Conflicting information regarding the benefits of hydroxychloroquine/chloroquine and azithromycin in coronavirus disease 2019 (COVID-19) treatment and hypothetical concerns for drugs, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have challenged care during the pandemic.1 However, limited data are available about how prescription of these therapies has changed. The objective of this exploratory analysis was to evaluate prescription patterns of these therapies, along with other commonly used drugs for reference, in the United States during the COVID-19 pandemic. We hypothesized that the prescription of hydroxychloroquine/chloroquine and azithromycin would exceed historical estimates while ACE inhibitor/ARB use would be reduced.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Haider J. Warraich, MD, VA Boston Healthcare System, 1400 VFW Pkwy, 4B-132, Boston, MA 02132 (hwarraich@partners.org).

Accepted for Publication: May 13, 2020.

Published Online: May 28, 2020. doi:10.1001/jama.2020.9184

Author Contributions: Drs Vaduganathan and Warraich had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Vaduganathan, van Meijgaard, Warraich.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Vaduganathan, Mehra, Warraich.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Vaduganathan, van Meijgaard, Warraich.

Administrative, technical, or material support: van Meijgaard, Warraich.

Supervision: van Meijgaard, Warraich.

Conflict of Interest Disclosures: Dr Vaduganathan reported being supported by the KL2/Catalyst Medical Research Investigator Training award (National Institutes of Health/National Center for Advancing Translational Sciences Award UL 1TR002541); serving on advisory boards for Amgen, AstraZeneca, Baxter Healthcare, Bayer AG, Boehringer Ingelheim, Cytokinetics, and Relypsa; and participating on clinical end point committees for studies sponsored by Novartis and the National Institutes of Health. Dr van Meijgaard is an employee of GoodRx. Dr Mehra reported receiving travel support and consulting fees, paid to Brigham and Women’s Hospital, from Abbott; fees for serving on a steering committee from Medtronic and Janssen (Johnson & Johnson); fees for serving on a data and safety monitoring board from Mesoblast; consulting fees from Portola, Bayer, and Triple Gene; and fees for serving as a scientific board member from NuPulseCV, Leviticus, and FineHeart. Dr Mehra also reported receiving personal fees from Baim Institute for Clinical Research and Roivant. Dr Joseph reported receiving grants from Novartis, Amgen, Otsuka, and Kowa and is a consultant for Novartis. No other disclosures were reported.

Additional Contributions: We acknowledge Diane Li, BA, and Amanda Nguyen, PhD, employees of GoodRx, who assisted with curation and analysis of the data. They did not receive additional financial compensation for these contributions.

Disclaimer: These analyses are based on a representative sample of US pharmacy claims and not based on GoodRx transactions.

References
1.
Vaduganathan  M , Vardeny  O , Michel  T , McMurray  JJV , Pfeffer  MA , Solomon  SD .  Renin-angiotensin-aldosterone system inhibitors in patients with COVID-19.   N Engl J Med. 2020;382(17):1653-1659. doi:10.1056/NEJMsr2005760PubMedGoogle ScholarCrossref
2.
van Meijgaard  J , Li  D , Marsh  T , Nguyen  A . GoodRx research data description. Published April 2020. Accessed April 26, 2020. https://www.goodrx.com/blog/wp-content/uploads/2020/04/GoodRx-Research-Data-Description.pdf
3.
Gautret  P , Lagier  JC , Parola  P ,  et al.  Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial.   Int J Antimicrob Agents. Published online March 20, 2020. doi:10.1016/j.ijantimicag.2020.105949PubMedGoogle Scholar
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Liu  M , Caputi  TL , Dredze  M , Kesselheim  AS , Ayers  JW .  Internet searches for unproven COVID-19 therapies in the United States.   JAMA Intern Med. 2020. doi:10.1001/jamainternmed.2020.1764PubMedGoogle Scholar
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Food and Drug Administration. Current and resolved drug shortages and discontinuations reported to FDA. Published March 31, 2020. Accessed May 11, 2020. https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Hydroxychloroquine%20Sulfate%20Tablets&st=c
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