Ended soon
State and local
governments across the United States have obtained about 30 million
doses of a malaria drug touted by President Trump to treat patients with
the coronavirus, despite warnings from doctors that more research is
needed.
At least 22 states and Washington, D.C., secured shipments of the drug, hydroxychloroquine, according to information compiled from state and federal officials by The Associated Press. Sixteen of those states were won by Trump in 2016, although five of them, including North Carolina and Louisiana, are now led by Democratic governors.
Supporters say
having a supply on hand makes sense in case the drug is shown to be
effective against the pandemic that has devastated the global economy
and killed nearly 200,000 people worldwide, and to ensure a steady
supply for people who need it for other conditions like lupus.
But health experts worry that having the drug easily available at a time of heightened public fear could make it easier to misuse it. The U.S. Food and Drug Administration on Friday warned doctors against prescribing the drug, hydroxychloroquine, for treating the coronavirus outside of hospitals or research settings because of reports of serious side effects, including dangerous irregular heart rhythms and death among patients.
It’s
the latest admonition against the drug that Trump mentioned 17 times in
various public appearances, touting its potential despite his own
health advisors telling him it is unproven.
Oklahoma
spent $2 million to buy the drugs, and Utah and Ohio have spent
hundreds of thousands on purchases. The rest of the cities and states
received free shipments from drug companies or the U.S. government over
the last month. Ohio received a large donation from a local company.
Several
states including New York, Connecticut, Oregon, Louisiana, North
Carolina and Texas received donations of the medication from a private
company based in New Jersey called Amneal Pharmaceutical. Florida was
given 1 million doses from Israeli company Teva Pharmaceutical.
The Federal Emergency Management Agency said Friday it has sent out 14.4 million doses of hydroxychloroquine to 14 cities, including Washington, D.C., Philadelphia and Baltimore, from the federal government’s national stockpile, a source that also provided South Dakota and California with supplies. The agency said earlier this month it had sent 19 million tablets and didn’t explain the discrepancy between the two figures. The U.S. government received a donation of 30 million doses from Swiss drugmaker Novartis on March 29 to build up the stockpile, which does not normally stock the drug.
“If he (Trump)
hadn’t amplified the early and inappropriate enthusiasm for the drug, I
doubt if the states would have even been aware of it,” said Dr. Kenneth
B. Klein, a consultant from outside of Seattle who has spent the last
three decades working for drug companies to design and evaluate their
clinical trials.
Klein
said it’s understandable that government and health officials looked
into hydroxychloroquine — which is approved for treating malaria,
rheumatoid arthritis and lupus — as a possible remedy during a
frightening pandemic, but the time and energy has been misspent. The
potential side effects are worrisome, especially because many
coronavirus patients already have underlying health conditions, he said.
“The states and the federal government are reacting in light of that fear. But it’s not a rational response,” Klein said.
Doctors
can already prescribe the malaria drug to patients with COVID-19, a
practice known as off-label prescribing, and many do. Medical and
pharmacy groups have warned against prescribing it for preventive
purposes. The FDA has allowed it into the national stockpile, but only
for narrowly defined purposes as studies continue.
Utah
Gov. Gary Herbert, a Republican, has previously acknowledged that the
drug is “not without controversy,” but defended the state’s efforts to
build up a supply. As questions mounted Friday, though, he distanced
himself from an $800,000 purchase the state made from a local company
and said it would be investigated.
Herbert
also halted a plan to spend $8 million more to buy 200,000 additional
treatments. “The bottom line is, we’re not purchasing any more of this
drug,” he said.
Other
states have received it from the federal government. South Dakota, with
a population of 885,000 people, received 1.2 million doses and is using
the drug for a trial as well as doctor-approved prescriptions for
COVID-19 positive patients.
South
Dakota Gov. Kristi Noem, a Republican and Trump ally, said earlier this
month she pushed the White House to provide enough hydroxychloroquine
to give it to every hospitalized person, others who are vulnerable to
the coronavirus and “front line” health care workers. As of Tuesday,
Sanford Health said there were 200 patients who have recovered from
COVID-19 in a registry, and that some of them may have taken
hydroxychloroquine, but it was not a requirement.
It
is one of several states that say they are using some of the doses for
clinical trials going on to assess whether the drugs has benefits for
COVID-19 patients.
Many
states, however, have opted to steer clear over concerns about side
effects and lingering questions about the drug’s effectiveness. At least
one of those states is led by a Republican governor, Tennessee, where
the state’s Department of Health sent a letter warning against using the
drug or hoarding it.
“We
were seeing a flood of inappropriate prescribing and hoarding, quite
frankly,” Health Commissioner Lisa Piercey told reporters.
Kansas
health director Dr. Lee Norman said the state has no plans to buy the
drug because evidence is lacking that it helps treat COVID-19.
Most
states aren’t paying for the drug, and it’s not clear why Utah didn’t
get it from the federal reserve or a donation from a business like
Amneal Pharmaceutical.
News
releases from state governments show the New Jersey-based company has
sent millions of doses of the drug free of cost to states, including 2
million to New York and 1 million to Texas. A company spokesperson
declined to provide a list of donations or answer other questions from
The Associated Press
Pharmaceutical
companies can often manufacture pills they already make fairly cheaply.
The donations may have been done to earn good publicity while setting
it up to make future sales if hydroxychloroquine ends up being a
reliable treatment for the virus, Klein said.
Controversy has swirled around the drug since Trump started promoting it in the White House briefing room on March 19.
He
mentioned the drug in briefings through April 14, and the White House
distributed press releases praising Trump’s efforts to stockpile it for
use in areas of the country hard-hit by the virus. But for the past
week, as studies have shown mixed or even harmful results, Trump has
gone silent on the drug.
Asked
about it Thursday, Trump said he hadn’t heard of the a study done at
U.S. veterans hospitals with preliminary results that showed no benefit,
and rejected the notion he had stopped promoting hydroxychloroquine as a
cure.
“I haven’t at all. I haven’t at all,” Trump said. “We’ll see what happens.”
