Hydroxychloroquine sales spiked almost 100% in Australia at start of Covid pandemic, study finds

The amount of hydroxychloroquine and ivermectin dispensed from Australian pharmacies increased significantly in 2020 as the Covid pandemic took hold, according to new research.

Analysis of six publicly subsidised drugs – including hydroxychloroquine, ivermectin, corticosteroids and the common antibiotic azithromycin – found Covid-related changes in prescription patterns in Australia.

The study, a preprint that has not yet undergone peer review, used dispensing data to quantify the number of prescriptions that had been filled at pharmacies between January and November last year.

The researchers noted a 99% increase in hydroxychloroquine dispensing in March 2020, about 30% of which was the result of new prescriptions.

This was around the time the drug – which has been shown to be ineffective against Covid-19 – was touted overseas by figures including Elon Musk and former US president Donald Trump.

Dr Andrea Schaffer, a senior research fellow at the University of New South Wales and the study’s first author, said: “We saw that use in people who hadn’t previously been using hydroxychloroquine actually tripled in March, with an increase in prescribing by general practitioners when normally it is prescribed by specialists.”

More than 40% of the hydroxychloroquine prescriptions in 2020 were made by GPs, compared to 25% in 2019. The drug is used to treat autoimmune disorders including rheumatoid arthritis and lupus, and is more commonly prescribed by rheumatologists.

“The fact that we are observing changes in the pattern of use, who’s using it and who’s prescribing it suggests that it’s probably not being used by the typical population,” Schaffer said.

There appeared to be stockpiling of multiple medicines among existing users in March, likely due to concerns about supply chains being disrupted, but the rise in new users of hydroxychloroquine suggested it was Covid-related.

New use of ivermectin doubled in May 2020, and an increase in dispensing was sustained over several months later in the year.

“That’s pretty consistent with when it was first identified as potentially being disease-modifying for Covid,” Schaffer said. Studies suggesting ivermectin can effectively treat Covid have not held up under rigorous scrutiny.

Guardian Australia revealed in July that research into its purported benefits had been retracted over serious ethical concerns.

The medicines study was limited to statistics from 2020, but preliminary data indicated the rise in ivermectin use continued in 2021, Schaffer said.

The Therapeutic Goods Administration issued a warning in August against Australians taking ivermectin for Covid-19, after a tenfold increase in importation of the drug. It banned off-label use of the drug in September, after a three-to-fourfold increase in prescriptions in recent months, effectively preventing GPs from giving it to Covid patients.

As Covid case numbers were relatively low in Australia last year, it was difficult to know whether the increased dispensing of hydroxychloroquine and ivermectin was driven by people actually using the drugs to treat Covid, or pre-emptively accessing them in the absence of infection, Schaffer said.

Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong who was not involved in the study, said the research pointed to a reasonable number of people being prescribed hydroxychloroquine and ivermectin without benefit. “There are harms associated with that.”

“It may not be surprising to hear that misinformation has a demonstrable impact on people’s prescribing trends, but it is important to note that when people promote drugs in the media and to the public, there is a real impact,” he said.

Schaffer said hydroxychloroquine dispensing figures dropped off quickly, likely as a result of the TGA increasing prescription restrictions.

“What it really highlights … is the importance of having access to timely data that we can use to identify problems with medicine use early on, so that regulators can respond quickly to limit inappropriate prescribing,” she said.

The researchers also noted low use of corticosteroids and azithromycin from March onwards. This was likely related to a reduction in other respiratory infections as the result of Covid public health measures.