Insurers are covering the cost of anti-parasitic drug ivermectin as a treatment for COVID-19 despite a lack of evidence surrounding its safety and efficacy, according to a new study.
The Food and Drug Administration has not authorized or approved ivermectin to treat COVID-19, and in fact, has released several statements advising against it. Clinical trials assessing ivermectin tablets to prevent and treat COVID-19 are ongoing. But a study published in JAMA by a team from the University of Michigan and Boston University found that the use of oral ivermectin surged 24-fold between December 2020 and March 2021, and insurers paid nearly 61% to 74% of the total costs.
Assessing claims data, the authors estimated that of the 88,000 ivermectin prescriptions filled in one week in Aug. 2021, approximately 4% were for the drug's approved purpose. Before the pandemic, the Centers for Disease Control and Prevention said only 3,600 ivermectin prescriptions were filled each week.
According to the report, insurers paid nearly $2.4 million for the prescriptions that week. Looking at claims data for an entire year, the total would be approximately $130 million.
"Insurers usually don't cover ineffective treatments, or at least make patients pay for most of the cost," Kao-Ping Chua, co-author of the study, said. "Our study suggests that they are treating ivermectin prescriptions for COVID-19 differently. In doing so, they are reducing barriers to an ineffective drug that some are using as a substitute for COVID-19 vaccination or evidence-based treatments."
Chua, a pediatrician at Michigan Medicine's Children's Hospital, and co-author Nora Becker of Boston University have proposed requiring doctors to fill out a prior authorization form with their justification for prescribing the anti-parasitic drug. The authors concede that this would result in barriers for patients who require ivermectin for the FDA-approved use to treat worms, head lice and some skin conditions, but the impact would be far less than those being given the drug for COVID-19.
"Our point is simply that insurers shouldn't cover these prescriptions unless ivermectin proved to be an effective COVID-19 treatment," Chua said.
Eric Musser, director of federal affairs for the National Committee for Quality Assurance, a not-for-profit that provides accreditation and performance metrics for physicians, health plans and medical groups, said they take FDA recommendations "very seriously."
"Anything we might include in our standard for care around COVID or other conditions would rely on the facts," he said.