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Post: : Ivermectin and hydroxychloroquine more likely to be prescribed in Republican counties, study finds

A new study found that hydroxychloroquine and ivermectin were more likely to be prescribed as COVID-19 treatments in U.S. counties with a higher rate of Republican voting.

Hydroxychloroquine is an antimalarial that can also be used to treat lupus and rheumatoid arthritis; ivermectin is an antiparasitic that’s prescribed for both humans and animals. 

Scientists have proposed that both of the decades-old pills could work against COVID-19, though neither drug has shown in rigorous clinical trials that it provides a benefit to people who have tested positive for SARS-CoV-2, the coronavirus that causes COVID. (There are several gold-standard trials underway for ivermectin, with results expected in the next month or so.)

But the lack of definitive clinical data hasn’t stopped some from believing that hydroxychloroquine and ivermectin do, in fact, work as COVID-19 treatments or prophylactics.

Read MarketWatch’s deep dive into ivermectin: ‘You will not believe what I’ve just found.’ Inside the ivermectin saga: a hacked password, mysterious websites and faulty data.

Hundreds of thousands of prescriptions for ivermectin were written during the pandemic, including more than 450,000 in August 2021 alone. Over the course of 2021, ivermectin was promoted as a viable COVID-19 treatment by embattled Spotify
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podcaster Joe Rogan, Sen. Ron Johnson (R-Wis.) and Rep. Marjorie Taylor Greene (R-Ga.), and organizations including the Front Line COVID-19 Critical Care Alliance (FLCCC).

From the archives (May 2020): Republican House member from Kansas says he and multiple family members are taking hydroxychloroquine to ward off coronavirus

Green Bay Packers quarterback Aaron Rodgers said he took ivermectin and hydroxychloroquine, referring to it as HCQ during an interview in November, when he tested positive for the virus.  

“There’s never been anything like this,” Michael Barnett, an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health and lead author of the study, said in an interview.

And so the goal of this study, according to Barnett and the other researchers at Harvard T.H. Chan, was to look at prescribing patterns for hydroxychloroquine and ivermectin in 2020 and compare them with county-level voting records from the 2020 presidential election. 

They examined medical claims data from January 2019 to December 2020 provided by UnitedHealth Group’s
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OptumLabs, according to the research letter, which published Friday in JAMA. The researchers then compared hydroxychloroquine and ivermectin against two control drugs, methotrexate sodium (a chemotherapy) and albendazole (a tapeworm treatment). Neither of the control drugs have been proposed as COVID-19 treatments.

The researchers found that new prescriptions for hydroxychloroquine and ivermectin were higher in counties that had a higher incidence of Republican voting in 2020. This raises questions about how personal politics can influence medical decision making, they said.

“U.S. prescribing of hydroxychloroquine and ivermectin during the COVID-19 pandemic may have been influenced by political affiliation,” the researchers concluded. “Because political affiliation should not be a factor in clinical treatment decisions, our findings raise concerns for public trust in a nonpartisan health care system.”

Key Words (April 2020): Trump again touts unproven drug to treat coronavirus: ‘What do you have to lose?’

They noted that prescriptions for hydroxychloroquine, which was authorized as a COVID-19 drug by the Food and Drug Administration in the earliest days of the pandemic, waned after the regulator pulled the emergency-use authorization in June 2020.  At that time, several studies indicated the drug didn’t work as a COVID-19 treatment.

And people in the U.S. began didn’t really start to take notice of ivermectin until late 2020. A deeply flawed preprint that promised incredible benefits for ivermectin was published in November 2020, and then congressional testimony in December 2020 from a physician named Dr. Pierre Kory that cited the flawed research went viral. (That testimony came about when Sen. Johnson extended an invitation to testify to Kory, a founding member of the FLCCC and a critical-care physician in Johnson’s home state of Wisconsin. The preprint was withdrawn in July 2021; Kory recently told MarketWatch that flawed study “stinks.”)

Key Words (July 2020): Trump trade adviser Peter Navarro complains in MSNBC interview that he’s ‘literally sitting on 63 million doses of hydroxychloroquine in the FEMA strategic national stockpile that I can’t give away’

One caveat to the research published in JAMA is that the researchers could not identify if prescribers or patients or some combination of both parties contributed to the increase in prescriptions in these counties.

Going forward, Barnett is unsure whether the upcoming clinical-trial data for ivermectin will change the opinions of prescribers, even if the studies from the University of Minnesota and Duke University’s medical school demonstrate that ivermectin is not a viable COVID-19 treatment.

“It may not have that big of an impact,” he said. “The evidence didn’t change hydroxychloroquine.”

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